After an abysmal turnout by the uninsured during the first open enrollment period, the Obama Administration completely locked down the Department of Health and Human Services (HHS) from releasing detailed enrollment data, particularly anything pertaining to the number of uninsured that purchased a qualified healthcare plan through the state and federal healthcare exchanges.
The Obama Administration had three years and spent nearly $1 billion taxpayer dollars to enlightening us all on the wonders of ObamaCare. And as the opening day neared it was the President himself who repeatedly touting what a great success the individual mandate was going to be in bringing affordable healthcare to the 28 million uninsured individual who qualified to participated on the healthcare Marketplace. And yet, so few showed that the administration was embarrassed to make public the enrollment figure.
The first open enrollment period was supposed to be the biggie with the millions of individuals who had been denied access to healthcare insurance due to a pre-existing condition knocking down the doors to sign up, along with others who the administration claimed always wanted healthcare insurance but were simply priced out of the marketplace. As it turns out, only a handful of those thought to be at the front of the line on opening day ever turned out during the inaugural 6 month long open enrollment period. Best estimates at the time were that just over 1 million of the 8.1 million who purchased a healthcare plan through the exchanges came from the pool of 28 million uninsured. The balance was made up of individuals who had their non-ACA compliant plans canceled and re-insured themselves through the exchanges. The Obama Administration never put an official head count to the number of uninsured who purchased and maintained a healthcare plan during the open enrollment period and they liked it that way.
The second open enrollment period fared no better than the first and the Obama Administration remained just as tight lipped to the number of the nations uninsured that purchased a healthcare plan through the exchanges. And while they made no mention of this failure, the administration was constantly patting itself on the back for its success in enrolling millions on to taxpayer funded Medicaid as a result of the program’s expansion.
At the close of the second open enrollment period, best estimates at the time were that as many as 4 million of the nations uninsured might now have obtained healthcare insurance through the exchanges. However, as more information became available, that number slowly dwindled to as few as three million. It should also be noted that at the time ObamaCare was passed in to law, the administrations original enrollment goal for the close of the second open enrollment period was to have insured 10 million of our nation’s uninsured through the state and federal healthcare exchanges.
Drilling Down on Enrollment
Two reports recently released by the HHS together have helped to shed new light on enrollment of the uninsured through the healthcare exchanges.
First is the ASPE Date Point Report. Released this past September, from this report we can see that HHS has adopted the figure of 15.3 million as the number of people they are claiming to have gained healthcare coverage since the beginning of open enrollment back in October of 2013. I say adopted as this is not a figure generated by HHS but instead one provided through an independent survey conducted by Gallup-Healthway Well-Being.
The 15.3 million figure reported by Gallup-Healthway and adopted by HHS is reflective of all who have gained some form of healthcare coverage, since open enrollment first began, regardless of source. In other words, amongst the 15.3 million are all those who are now covered through the Medicaid Expansion; those who purchased a healthcare plan on the private marketplace; those who are now insured through their employer and of course those who obtained healthcare coverage through the state and federal exchanges.
Just to be sure we are clear, this 15.3 million enrollment figure includes the entire universe of people that have gained some form of healthcare coverage since open enrollment started. Also, this third party generated figure, adopted by HHS, is not based on an actual count and there is nothing that leads us to believe that HHS has validated it in any way.
If it strikes you as odd that HHS does not use their own enrollment count, it should as they most certainly have the resources to do so.
Second we have the CMS MedicaidEnrollment Report. CMS publishes Medicaid enrollment updates monthly, this particular report being the latest release and represent enrollment through July of this year. In the report we find that CMS has reported a figure of 13.2 million individual have taken advantage of the Medicaid expansion through July of this year. Unlike the previous report, Medicaid enrollment is an actual count compiled internally by CMS so they own this.
We will use the Medicaid enrollment figure to help us determine enrollment through the healthcare exchanges but first I am going to take the liberty of bumping it up by 200,000 to make it more representative of what enrollment looked like in September thus matching the same time period of the previously discussed ASPE report. Bump the Medicaid enrollment figure to 13.4 million errors well on the side of caution, falling well below the average increase in Medicaid enrollment for the past three reported months.
Drum Roll Please
If we were to assume that since January 1, 2014 no uninsured person eligible to participate on the healthcare Marketplace became insured through their employer or an off-exchange insurer, then by removing the number of individuals who have taken advantage of the Medicaid Expansion (13.4 million) from the total reduction of the uninsured since open enrollment began (15.3 million) we would arrive at the number of individuals who have obtained healthcare insurance through the state and federal exchanges. Under these assumptions, 1.9 million people obtained healthcare insurance through the state and federal healthcare exchages.
Out of the pool of 28 million uninsured who are qualified to participate on the ObamaCare created healthcare Marketplace, no more than 1.9 million have done so over the course of two open enrollment periods. That does not speak will for the healthcare law that was intended to bring these 28 million people access to affordable healthcare. 1.9 million is also significantly less that previous projections and is less than 20% of the administration targeted enrollment for 2015, as originally forecasted by the CBO and used to sell ObamaCare. This is also in no way, shape or form what was promised to the American people when congressional Democrats and the President jammed this law down our throats.
And 1.9 million still does not represent the number of people who actually purchased a healthcare plan through the state and federal healthcare exchanges as it still includes those who gained healthcare insurance through their employer and those individuals who purchased healthcare insurance through a private or off-exchange source.
How Much Worse Does it Get?
It gets quite a bit worse actually.
We do not know the breakdown of the 1.9 million people who gained healthcare coverage through other means than the Medicaid Expansion but what we do know is that, since the opening of the healthcare Marketplace, 5 million new jobs have been created. If just 10% of those new jobs provided healthcare insurance to their new employees this 1.9 million figure would be reduced by a half million. If 44.5% of those new jobs provided healthcare insurance to their employees, as reported in a 2013 Gallup-Healthwaystudy, it would wipe out the 1.9 million figure in its entirety and then some.
How many of these new jobs are providing the employee with healthcare insurance we do not know but I think it is more than safe to assume that more than 10% do and it would not be inconceivable that 40% could be doing so, based on current trends. This certainly gives us something to think about. And let’s not forget, there are still those individual who purchased their healthcare plans off-exchange.
And It Could Be Even Worse!
Gallup-Healthway Well-Being is not the only industry expert studying the effect that ObamaCare has had on the reduction of the nations uninsured. Other well respected organizations such as the Rand Corp, the Commonwealth Fund and the Urban Institute all have performed similar studies with varying results.
For example, sometime after the close of the first open enrollment period, each of these groups conducted their own studies on the effect ObamaCare was having on the reduction of the uninsured. Their results ranged from 9.5 million to as low as 8 million. For the same period the Gallup-Healthway survey concluded a reduction of 10.3 million, more than 20% higher than the lowest resulting study. It would be impossible to determine which of these studies was the most accurate and it is not important to do so. What is important is to understand and accept that there could be as much as a 20% variation in the results of these studies.
Clearly, which study HHS choses to adopt to represent the overall reduction of the nations uninsured will have a significant impact when determining the number of people who could have possibly obtained a healthcare plan through the state and federal healthcare exchanges. If you were to lower the current adopted figure of 15.3 million by 20% you would actually arrive at a net negative enrollment through the exchanges. (12.2 million – 13.4 million)
Enrollment May Even Be Upside Down
The pool of 28 million people qualified to participate on the healthcare Marketplace may have actually grown since open enrollment began.
As many as 2.2 million people are likely to have gained healthcare insurance through their new employer since ObamaCare enrollment started. This figure surpasses the 1.9 million maximum non-Medicaid Expansion enrollments to date. For this to happen the pool of uninsured qualified to participate on the healthcare Marketplace would have to grow by 300,000. Of course, every one of those 2.2 million who likely gained insurance through their employer were not all uninsured but a good majority of them were.
A fair look at the overall reduction of the nations uninsured would all but close the gap between the overall reduction figure and those who have taken advantage of the Medicaid Expansion. There being a 20% disparity between the results of the highest and lowest studies conducted by four of industries leading experts, if we were to take the average results the overall reduction in the nation’s uninsured would be reported at roughly 13.8 million. With 13.4 million having taken advantage of the Medicaid Expansion, this accounts for almost all of the nation’s reduction of the uninsured leaving virtually all of the pool of 28 million eligible to participate on the healthcare Marketplace untouched.
If the full 20% disparity were applied, the overall reduction in the nation’s uninsured would be reported at around 12.2 million. Taking in to consideration the 13.4 million who have taken advantage of the Medicaid Expansion, this would mean that the pool of 28 million people who are eligible to participate on the healthcare Marketplace would have to grow by 1.2 million.
One Last Point
All this number crunching has my head spinning but it is important to take the time to drill down on these figures and understand how effective (or ineffective) the individual mandate has been in reducing the pool of 28 million uninsured Americans who are not qualified for Medicaid. As you can see, things do not look so good, in fact that look beyond terrible. Based on these finding, the Individual Mandate is a total failure and may actually be driving the uninsured rate up instead of down.
This was concluded using numbers derived, adopted and published by HHS and therefore are endorsed by the Obama Administration. These are their numbers, they own this!
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