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Norm's Desk

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How many Obamacare exchange enrollees are there?

In his State of the Union speech, the President announced that 9 million people had enrolled for health plans on the exchange.  This is an incredible number compared to the number of enrollees just a few weeks ago.  Does this mean that the exchange is now a huge success?  A turnaround of epic proportions with millions clamoring for its products.  Well . . . 

From Byron York:
The number is a little larger now, since the figures are a few weeks old. But there is strong new evidence to suggest the administration's claims are grossly exaggerated and deeply misleading. Obamacare is not doing nearly as well as the president wants you to believe.
First, Medicaid. This week, the health consulting firm Avalere found that only 1 to 2 million of the 6.3 million who signed up for Medicaid were new enrollees brought into the program by Obamacare. The rest were people who were eligible and would have signed up for Medicaid irrespective of Obamacare, in addition to people who were already on Medicaid but were renewing their status. (The researchers reached their conclusion by comparing the Obamacare sign-ups with a recent period before the new health law went into effect.)
If the Avalere report is accurate — and experts are taking it seriously — then less than one-third, and perhaps less than one-quarter, of the new Medicaid sign-ups cited by the administration were previously uninsured people gaining coverage because of Obamacare. That's a major shortfall.
The numbers are important not only for policy, but for politics. In recent months, as the failures of the Obamacare website left the administration reeling and its supporters disheartened, Democrats often pointed to the number of Medicaid sign-ups as an example — the only example — of a shining success for Obamacare. Now that success looks a lot less shiny.
"It's a surprise because of all the outreach and the fact that Medicaid is free — there is no premium paid by individuals," said health care analyst Bob Laszewski. "This really is perplexing — they can't give it away!"
Then there are the roughly three million people said to have signed up for private insurance. In mid-January, the Wall Street Journal reported that a relatively small percentage of the new sign-ups were previously uninsured Americans gaining coverage through Obamacare. The rest were people who were covered and lost that coverage in the market disruptions largely caused by Obamacare.
A McKinsey and Co. survey cited by the Journal found that just 11 percent of private insurance signups were people who previously had no coverage. Other surveys found that about one-quarter of new sign-ups were previously uninsured.
Whatever the precise number, it appears that a large majority of the activity in Obamacare private coverage sign-ups is essentially a churn operation: The system throws people out of their coverage, and then those people come to the system to sign up for new coverage, and that is reported as a gain for Obamacare.
Let's give them credit for something.  Millions of people are enrolling through the exchange website.  Whether they know what they are buying or whether they have actually bought remains an open question.  But, things are apparently much better with than they were 60 days ago.  But these numbers are still very problematic.  Who is signing up for private insurance?  Somewhere between 75% and 90% of them were people with insurance policies before the ACA took effect, had their plans cancelled by the ACA, and had to reenroll in the exchange to keep their insurance.  We have a term for this in the insurance industry.  It is called "churn."  It is what less than scrupulous agents do when they have no way of gaining new business or growing their existing business.  They try to rewrite existing policies for no reason to obtain new commission bonuses and the like.  You are not growing or accomplishing anything.  You are just trying to squeeze more juice out of the same lemon.
This weeks's Congressional Budget Office estimate were also devastating.  They have revised their numbers of how many jobs will be lost due to the ACA from 800,000 to 2.5 million.  But, don't worry.  We are being told that this is a GOOD thing because these are people that will simply choose not to work.  If this were true, we should all be ecstatic by the fact that our labor force participation rate has declined every year since 2008 and now stands below 63%.  Growing economies have increasing labor participation rates.  Stagnating economies do not.  Moreover, the CBO has estimated that once the ACA takes full effect, there will still be 31 million Americans without health insurance.  Talk about bang for your buck!

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