Posted on 11/14/2013 6:32:18 AM PST by SeekAndFind
HHS released the enrollment numbers for the federally run health-care exchange and most of the state-run exchanges today, the first comprehensive set of data that had been released so far. Bearing in mind that it’s the first month of enrollment, and we still don’t know much about the customers, here are a few thoughts on what they show us:
80 percent (or more) of the people who’ve gotten insurance so far have done so through Medicaid: About 400,000 people who’ve entered the exchanges have been determined eligible for Medicaid, while about 100,000 have selected an insurance plan for which they’re eligible (obviously these two statistics are not strictly comparable, but HHS juxtaposed them and Nancy Pelosi added them together). Hundreds of thousands of more people are set to enroll in Medicaid beyond the 400,000 group, too, because a number of states are rolling the beneficiaries of their existing free or heavily subsidized insurance programs for low-income individuals onto the Medicaid-expansion rolls — meaning the proportion is, currently, much higher even than 80 percent. This matters because, in short, Medicaid is a poorly run single-payer plan that does very little to improve health-care outcomes, but does lots of damage to government budgets. There’s a reason why House Democrats didn’t propose expanding it to much higher income levels than the law eventually did, and it looks like much more of Obamacare will be the Medicaid expansion than we thought.
120,000 of those determined eligible for Medicaid come from states that haven’t agreed to help run the ACA expansion of the program; rather, they were already eligible under the existing federal system, and for some reason didn’t enroll until the current push for people to sign up. This is called the “woodwork problem,” referring to enrollees “coming out of the woodwork” — it’s a problem because, unlike the Medicaid expansion, which (for now) the federal government will pay for almost entirely, somewhere between 30 and 50 percent of the cost of these new enrollees will fall on the states, who are compensated at normal Medicaid rates, not the juiced expansion rates. Medicaid is now one of the two biggest problems on almost every state’s budget (along with pensions); even a few thousand more enrollees in Medicaid can be quite costly.
Three in ten people were eligible for subsidies, out of the 1.08 million who filled out enough information on an exchange to see what plans they can get and at what price were eligible for. Just 23 percent of people on the state-run exchanges have been found eligible for subsidies, while 34 percent of people in states using the federal exchange were. After one caveat — some people, by HHS’s definition, have been determined eligible for marketplace plans but their subsidy eligibility is pending — this is interesting: The CBO predicted that just 1 million out of the 7 million people who would enroll on the exchanges would be ineligible for subsidies. That’s one-seventh, when five-sevenths of those who’ve currently checked out plans, if they all sign up, will be unsubsidized. This can only be because the incomes of those who’ve applied are much higher than the CBO expected the eventual makeup of the risk pool to be — why might that be?
Half of Americans make low-enough incomes to qualify for subsidies, and low-income Americans are, of course, disproportionately uninsured, which is why the CBO predicted so many of the enrollees will be subsidized. This means the program may not be doing a very good job reaching out to the poor (an issue Representative Bill Cassidy, a doctor from Louisiana, raised when he visited NR a couple weeks ago — Obamacare isn’t well designed to reach the uninsured), though that could get better as time passes. It also may mean the pool is older than expected — older people make a lot more money than young people. Neither would be great for Obamacare: The former means it’s not substantially reducing the ranks of the uninsured, but simply absorbing existing individual-insurance market customers (or people who could afford insurance but couldn’t get it because of preexisting conditions), and the latter means the pool will be older and sicker than expected, so the rates haven’t been set high enough.
That said, higher-income people, holding the age distribution constant, do tend to be healthier, which means the exchanges will work better. And if the CBO’s subsidized-unsubsidized estimate turns out to be off, the law will actually cost a lot less than expected. People also could be generally overstating their income — either because they’re making a mistake, or because they want to avoid being undercharged for insurance (if your income ends up higher than you tell the exchange, you’ll owe the IRS the undeserved subsidies, on your tax bill at the end of the year).
So, we have a system where people choose to sign up or not (for now).
In that system we have some people getting stuff for free
at the expense of others that sign up and pay a higher amount than they would outside the system.
And leftists wonder why they get a bunch of the former and very few of the latter?
How could they be such “Notsees” that they can’t predict this like we do?
I guess they’ll have to use more coercion and force to make the payers join the system to pay for the takers that enthusiastically sign up for freesht.
‘customers’, ‘enrollees’, ‘qualify for subsidies’, ‘checked out plans’, ‘eligible for marketplace’, ‘entered the exchanges’, blah, blah.
It’s all a bunch of hooey.
Tell us how many people actually entered a (valid) credit card number.
The statistician-liars in the federal government are citing 106,000 who have “selected a plan”. Please remember that, based on leaked info, this means that someone added a plan to the “shopping cart”.... it does not mean that they have committed to the plan, and certainly not mean that any payment has been done.
RE: It does not mean that they have committed to the plan, and certainly not mean that any payment has been done.
This brings a new meaning to the word — ENROLLMENT.
If I apply to a college, am I considered enrolled if I don’t pay my tuition?
When you consider the testimony from the hired contractor ($600M+), our ruler's people wanted it this way. They actually changed it so you had to sign up and give all your information before you could actually see your options. Ta-da! You are enrolled. Now please select which insurance you want and give us a credit card number. I doubt we'll ever see how much "revenue" Obamacare is now producing for the insurance company. I used to think this would be kept secret because of how high it is. Now it will be kept secret to hide the failure.
By the way, what about all those poor people, you know, the ones that don't have ID to show if laws require them at the voting booth. Can we assume that they all have credit cards, computers and high-speed internet so they can get this government goody?
Yes, yes you are and after 4 years just swing by and pick up your diploma at the drive-through window...........
What if you are late on your credit card payment, get sick, go to hospital. Will you be denied treatment?
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