How many of the Uninsured will ObamaCare Really Insure?

“I don’t have to explain to you that nearly 46 million Americans don’t have health insurance coverage today.  In the wealthiest nation on Earth, 46 million of our fellow citizens have no coverage.”  -  President Obama, August 2009

That same year, the Census Bureau reported that 48 million Americans lacked health insurance.

While the issue of affordability can be argued, the fact that ObamaCare did and continues to provide “access” to healthcare for those 48 million uninsured Americans remains true.  However, it was, is and will continue to be unrealistic to believe that the majority of those 48 million will ever actually gain any form of healthcare insurance coverage simply because it is mandated by law.

Yes, there has long been a group of Americans who have been denied or could not afford wanted healthcare insurance but this group makes up small fraction of the 48 million who were uninsured prior to the passage of ObamaCare.  The larger portion of that 48 million uninsured choose to opt-out of purchasing healthcare insurance on their own accord and have since shown to be just as unlikely to purchase healthcare insurance under mandate of law as the were prior to ObamaCare being enacted.

 

The Financially Secure “Opt-Outs”

Roughly 20% of the 48 million who have, in the past, chosen to “opt out” of purchasing healthcare insurance come from a group of hard-working, tax paying Americans who are financially secure.  This group of the uninsured has never been denied affordable healthcare insurance nor do they place a financial burden on the healthcare system.  This group “chooses” to pay for their healthcare needs “out of pocket” and, as a result, do not find themselves running to the doctor’s office every time they have a sniffle or a headache, a common abuse by those who have healthcare insurance.

Numbering nearly 10 million, the financially secure opt-outs have taken a much more cost effective approach to manage their own healthcare needs and, as we have experienced over the past two open enrollment periods, continue to opt-out of purchasing a traditional healthcare plan despite the federal mandate to do so.

 

The Young Invincibles

Numbering around 19 million, the young invincibles make up about 40% of the 48 million, as reported by the Kaiser Family Foundation.  While a significant portion of the uninsured, they are in large very healthy thus finding little need for healthcare insurance prior to the implementation of the new healthcare law.  Little has changed in the age of ObamaCare as this group has shown little desire to bear the bulk of the burden for the older and less healthy, by paying a disproportionate amount for healthcare insurance, a key component of the ObamaCare law. 

Like the financially secure opt-outs, this large group of the uninsured has never been denied affordable healthcare insurance.  Their insured counterparts, including hundreds of thousands of college and university students, typically took advantage of low cost “bare-bones” insurance plans that were both affordable and well suited to their particular need.  However, under ObamaCare, these well suited bare-bones healthcare plans are a thing of the past.

For those under the age of 26, the problem ObamaCare created by putting an end to the well suited catastrophic plans was mitigated though a provision in the law that allows these sub-26ers to remain on their parents insurance plans.  This provision in the law is said to have increased the number of insured sub-26ers by about 3 million, according to HHS.  For the balance of the uninsured young invincibles, they were left to purchased healthcare either from the private marketplace or though one of the state and federal healthcare exchanges.  To date, very few have done so.  They are still young, invincible and see little need to spend a large portion of their meager income on insurance that they do not believe they need.

 

Those Living in the Shadows

The homeless, addicts and other small groups of American’s that sadly live in the shadows of our society make up about 15% or roughly 7 million of the uninsured.  Most of these individuals have long been eligible for some form of healthcare assistance but for whatever reason most have chosen not to or have been unable to capitalize on these offerings.  However, since the HealthCare.gov website was launched about half of those living in the shadows have come out of the “woodwork” and have enrolled on to Medicaid.
 

Pre-Existing Conditions

Amongst the 48 million there are those that have, in the past, been denied insurance due to a pre-existing condition.  The Obama Administration did a masterful job at misleading the American people into believing that their numbers ran into the millions when in fact the number is actually quite low. 

In lieu of the “guaranteed issue” that went into effect on January 1, 2014 which no longer allows insurers to discriminate against a person having a pre-existing condition, the Pre-existing Conditions Insurance Plan (PCIP) provision was put in place.  The PCIP was a stop gap that made insurance available to high risk individuals with a pre-existing condition almost immediately after ObamaCare was passed in to law back in 2010. 

When the PCIP was being crafted, it was estimated that no more than 375,000 high risk individuals that would seek enrollment.  This, in addition to roughly 200,000 that were actively participating on 35 state operated High Risk Pools (HRP), brought the number of individuals in the pool of those with a pre-existing condition and possibly seeking healthcare insurance to 575,000.  Yet, of the 375,000 estimated to participate in the PCIP, less than one third or about 1/4 of 1% of the 48 million, enrolled on to the PCIP bringing the number of individuals with a pre-existing condition and seeking healthcare insurance to just over 300,000.  That’s a far cry from the millions the president had been touting.

 

The Semi-Low Income “Opt-Outs”

The balance of the 48 million are made up of the semi-low income “opt-outs”.  Prior to the passage of ObamaCare, this pool of about 12 million fell in to a grey area where their income was too high to qualify for Medicaid yet two low to be able to afford healthcare insurance without giving up basic necessities to live.  This created a forced healthcare insurance opt-out situation.

The expansion of Medicaid eligibility criteria has opened the door for these 12 million people, most all of which have or are expected to take advantage of the Medicaid Expansion.
 

The Numbers Fit

Of the 48 million who were uninsured when ObamaCare was passed in to law it looks as though as many as 18.5 million have or will eventually seek out healthcare insurance, mostly through the Medicaid Expansion.  The remaining 29.5 million look as though they will continue to opt-out of purchasing a qualified healthcare plan for a variety of reasons.

As for those who will continue to opt-out of purchasing a qualified healthcare plan, just as they have done in the past, the majority of the financially secure opt-outs will remain responsible for their own healthcare costs.  As well, the bulk of the young invincibles will remain healthy and without the need of costly healthcare insurance.  Those living in the shadows who remain uninsured of course will continue to be a financial burden on the healthcare system.

 

What about those Uninsured with a Pre-existing Medical Condition?

The question remains unanswered as to exactly how successful ObamaCare has been in insuring the pool of people with a high cost/high risk pre-existing medical condition and if the performance of the PCIP is any indication, the law is not helping near as much as is being claimed.

The PCIP attracted only 36% of the 375,000 participants as originally projected and over its short lifespan lost 23% of its 135,000 peak enrollment in its final year, despite rate reductions of 20%.  Additionally, 20% of PCIP enrollees failed to transfer to one of the state and federal healthcare exchanges before the PCIP provision expired, even after three extensions were granted for them to do so.

It’s hard to imagine HHS over projecting, by nearly 300%, the number of individuals with a pre-existing condition that were in need of healthcare insurance.  Even if the over projection was only 200%, this would still mean that 135,000 individuals with a pre-existing condition opted-out of the PCIP provision, this in addition to the 31,000 documented attrition and the additional 20,000 that did not transfer over to the healthcare exchanges. 

But there is no real way in knowing exactly how well those with a pre-existing condition are currently being treated by the ObamaCare law.  First, we are unsure as to exactly the number of individuals with a pre-existing condition that ObamaCare could have effected and second, there is no mechanism in place to determine a person enrolling on the healthcare exchanges was one of those individuals.  And what about the states that ended their HRP programs, how many of their enrollees found their way and purchased a healthcare plan through the healthcare exchanges?  There is no way of knowing for sure.

Eventually some group will do a study to try and determine just how many of those with a pre-existing condition ObamaCare is actually helping but for now, it looks as though far fewer are being helped that the Obama Administration would like us to believe.

 

The 2016 Open Enrollment Period Will Soon Be Upon Us

The third ObamaCare open enrollment period is just around the corner and this is a make or break for ObamaCare.

Over the 9 months that made up the first two open enrollment periods the healthcare exchanges managed to attract only about 3 million customers from the nation’s pool of the non-elderly, long term uninsured, a 70% shortfall from projection.  This leaves a lot of ground to make up in addition to another 6 million uninsured that were projected to enroll through the exchanges in 2016. 

Reaching the laws 2016 goal of reducing the number of uninsured by 16 million, through the purchase of a qualified healthcare plan, is a virtually insurmountable task, achieving even 50% of the goal looks to be out of reach.  But we must go through the motions and after the open enrollment period ends endure the countless ways the Obama Administration will try and defend an unpopular law that continues to fail to meet one of its primary objectives by a significant margin.

ObamaCare 2016 Open Enrollment - Three Data Points Does Form A Trend

Despite poor turnout by the uninsured on the state and federal ObamaCare exchanges, Congressional Republicans have remained largely silent on the issue of the underperforming healthcare exchanges and rightly so.

During the inaugural 2014 open enrollment period only 1.4 million of the 6.7 million individuals who purchased a healthcare plan through one of the state and federal healthcare exchanges came from the nation’s pool of uninsured non-elderly.  By the end of the second open enrollment period an additional 2.3 million joined the ranks of the nation’s insured.  Combined, the result of the two open enrollment periods decreased the nation’s number of uninsured nonelderly by roughly 3.7 million.

(Note:  Since the writing of this blog HHS has released new data which reduces the number of uninsured nonelderly who have purchased and maintained a healthcare plan through the exchanges significantly) 

The Obama Administration has never played up the enrollment through the healthcare exchanges and rightly so as they have been horribly off of projection.  The administration’s target for the 2014 open enrollment period was to insure 7 million of the nation’s long term uninsured and to increase that number to 10 million by the close of the 2015 open enrollment period.  They missed both projection by a significant amount.  It is important to note that these targets were the very same that were used by Democratic lawmakers, and others, during the pitch to get the American public on board with the president’s namesake law.

Republicans have as well remained relatively quiet on the failure of the healthcare exchanges to attract the uninsured although for a different reason. 

Two data points do not form a trend therefore, it would be disastrous for Republican lawmakers to publically call the program, still in its infancy stages, a failure based on such a limited amount of data, despite the healthcare exchanges obvious failure.  The stakes are so high for Democrats that such a challenge would be met with a litany of rebuttals which of course would be difficult to refute on the sole basis of two open enrollment periods.  But all that changes in less than nine months.

The administration is already fearing the worst for the 2016 open enrollment period and have every reason to.  They are at a total loss as for what to do about the poorly performing healthcare exchanges and to be honest, there is nothing short of a miracle that can be done. 

Driven by an even larger penalty for not complying to the federal mandate to obtain healthcare insurance coupled with what was then believed would be lower insurance premiums, the administration originally projected that 12 million of the nations uninsured nonelderly would take advantage of tax subsidies offered through the ObamaCare exchanges during the 2016 open enrollment period.  These projected 12 million individuals, along with the 10 million originally projected to have obtain a qualified healthcare plan during the first two open enrollment periods, would have raised the number of healthcare plans sold to the uninsured nonelderly to an astounding 22 million by the close of the 2016 open enrollment period if the healthcare exchanges were to perform as planned.

But reality speaks far louder than projections and the administration knows that it is all but a mathematical impossibility to achieve its original enrollment goals, it can’t even come close.  And so, Republican lawmakers sit and wait for that 3^rd data point which will establish an irrefutable enrollment trend of failure. 

There will be no excuses that can be made; no claims of inaccurate or unreliable enrollment data; no more saying that the law needs time to work; and most of all, no more spreading the narrative that republicans are targeting ObamaCare simply because they don’t like the president.  If the coming open enrollment period does not produce a significant number of long term uninsured signing up for a qualified healthcare plan, the fate of the law will be signed, sealed and will just be waiting for its finally delivery.  And the time to be delivered will come almost immediately.

If the healthcare exchanges fail to deliver in 2016 it will become one of the major talking points for the 2016 presidential election and with such a large number of republicans having thrown their name in the hat you can be assured that they will come together for the one common cause of staging an all-out assault on ObamaCare and the 2016 Democratic hopefuls who continue to support the law.

It will be impossible for the “party of care” to justify leaving between 10 and 15 million individuals uninsured above the 30 million originally projected by the administration.  As well, it will be impossible for democrats to justify keeping a law on the books that instead of making insurance affordable to all has priced healthcare insurance out of the reach of the average American even with subsidies.

Republican lawmakers have been criticized for not being more aggressive in their attempts to repeal and/or dismantle ObamaCare, waiting for this third data point is the reason why!

News Media Report Card on ObamaCare Tells Misleading Tale

Yesterday marked the 5 Year Anniversary of ObamaCare.  So how about we take a look at what the news media is saying about ObamaCare, 5 years after, and grade them on the job they are doing in providing truth and facts to the American people.  After all, that is what journalism is all about isn’t it, providing the truth and the facts?

We could pick any number of far left leaning so called “journalistic” sources to perform this exercise on but that would make this effort no better than the uber bias they most certainly inject into their piece.  Instead, we’ll use a story from Tribune News Service written by Tony Pugh that we found published on MSN news on Sunday titled:  Taking the pulse of Obama's health care lawat age 5

The opening paragraph sets the tone for what is a fairly long list of misinformation, but nothing we really have not heard before.

With more than 50 congressional repeal votes, a near-death Supreme Court experience and a botched marketplace debut to its credit, the Affordable Care Act has had a tortured five-year existence as the Republican Party's legislative enemy No. 1.

No, there have not been 50 congressional repeal votes for ObamaCare, nor has there been 40 or 30 or 20 or even 10.  Declaring that Republicans keep feudally attempting to repeal ObamaCare is a favorite of ObamaCare proponents that for some reason think congressional republicans are so stupid as to constantly call to vote on something they know they don’t have the votes for.  A full repeal vote for ObamaCare has been call only 7 maybe 8 times and each time as a part of process or record.  When the law was first passed of course there was an immediate repeal vote, republican lawmakers needed to be sure their unanimous position was on official congressional record.  The same holds true when republicans won back the House and again when they won back the Senate, those full repeal votes again are to put their position on record.  And each year, as part of the budget process, a full repeal vote is taken again, this is part of process.  

As for the rest of the ObamaCare repeal votes that liberal democrats keep rambling on about and the media keeps reporting, they simply do not exist.  There are a large number of votes on various pieces of ObamaCare that have received a repeal vote, several initiated by Democrats and many which have passed on a bi-partisan vote, but we would not want to confuse things with a few simple facts. 

The bottom line is that the vast majority of these so called 50 plus repeal votes, that are constantly being reported, are generated by yammering liberal democrats trying to mislead everyone into thinking that congressional republicans are really that stupid.  Sadly the media has chosen to parrot this tall tale told by democrats but then, why shouldn’t they be, their president repeats the same misleading facts!

But we are not going to let the media off the hook on this one just because the president is just as guilty of perpetuating an untruth that can be disproven in a 2 minute internet search.  Because of this we are going to grade this media claim a big fat “F”!


Scrolling down the article a bit, we run across this paragraph:

The nation's uninsured rate has plummeted as more Americans enroll in Medicaid or in federal and state marketplace coverage.

Another liberal and media favorite, misguided and you could even go as far as saying untruthful.   Yes, the number of uninsured in the nation has dropped significantly, almost all due to the Medicaid expansion.   The federal and stated marketplace {the ObamaCare exchanges} have performed miserably through both the 1st and 2nd open enrollment periods, failing to have enrolled even one third the number of uninsured they were intended, a critical measure of the success of ObamaCare that is repeatedly ignored and left out of the conversation. 

Why the media does not address Medicaid and the marketplace established by ObamaCare as two separate issues defies truthful reporting however, as we have learned, liberals seem to believe that any reduction in the number of the nations uninsured is a measure of success for the law regardless of any fiscal or economic ramifications much less the fact that the current trend indicates that the law will leave an additional 10 million without healthcare insurance above the 30 million that was already projected.

Only because of the liberal belief that enrollment in the ObamaCare exchanges is not a factor in measuring the success of ObamaCare do we grade this media claim a grade of “D” otherwise the author failing to differentiate enrollment between the two very different marketplaces would have earned this claim a grade of “F”.


The very next paragraph points out another long time misguided belief, perpetuated by the Obama Administration and bought, hook line and sinker, by those who wish to believe in all the great good the law is said to be doing.

The law's consumer protections and insurance-benefit requirements have improved the quality of coverage for millions of people who get health insurance outside the workplace.

This paragraph calls to the success of two very different aspects of ObamaCare, both equally as troubling once you find your way past the self-serving praise the administration gives itself for a job not so well done. 

First, consumer protections!  There are a number of consumer protections claimed by the administration to be a part of ObamaCare but the one of the most specific and most talked about is laws mandate which prohibits insurers from denying healthcare insurance to an individual due to a pre-existing condition.  The biggest fallacy about this particular protection is not of the protection itself but the grand embellishment to the American people as to its need, when trying to sell the law to us.  In an attempt to play on the people’s heart strings, the Obama Administration set out to convince We the People that millions upon millions of individuals in this country were suffering after being denied healthcare insurance due to a pre-existing medical condition.  This might be the grandest of all the misleading information that the president has posed upon the people.

Those crafting the ObamaCare law determined that the number of individuals suffering from a cost prohibitive pre-existing condition were fewer than 400,000, a far cry from the millions the administration led us all to believe would be helped by ObamaCare.  As it turns out, only about one third of those fewer than 400,000 projected found ObamaCare attractive and affordable.

One of the other consumer protections that I find particularly amusing is the claim that ObamaCare ends insurer discrimination against women.

Without argument, the healthcare needs of the average woman are greater and more costly than the healthcare needs of the average man and therefore the private healthcare insurance marketplace has historically priced their individual plans accordingly.  But this for decades has had liberal women’s groups up in arms, claiming discrimination and demanding equality.  And in ObamaCare, these people who have been waving the discrimination flag and fighting for their interpretation of equality have receive what they have been wishing for, at least that is what they see in their own blind ignorance.

The president made it part of his ObamaCare campaign to claim his grand healthcare reform would bring equality between men and women and it did.  By mandating that insurance rates could not be gender based, what the administration was able to do, through the laws “essential healthcare benefits” package, was to generate much needed revenue to cover other high cost issues by forcing men to pay for the same healthcare needs as women.  In doing so, those liberal ladies who screamed that they were being discriminated against gained their interpretation of equality.  Their rates did not go down but instead men’s rates went up as they now had to pay for healthcare benefits that they are physically incapable of utilizing.  In the minds of liberals, this brought fairness to the table and for insurers it was a fiscal windfall as it brought a new and guaranteed revenue stream to them.

This claim too also earns the grade of a “D”.  Other than the consumer protection that mandates those with a pre-existing condition cannot be denied healthcare insurance, there are no other consumer protections that have provided consumers any measurable protection while the essential benefits the administration speaks of had done a wonderful job in generating revenue to be shifted to other needing provisions of the law.  Why wasn’t this reported on?


The next paragraph in the article is simply laughable:

Premiums for marketplace health insurance have largely been reasonable and have increased only moderately thus far. Long-term cost estimates for providing coverage under the law have been falling.

I’m not even sure where to start with this three line bit of mumbo jumbo.  I guess on the positive side the author chose to use the word “moderately” instead of something you might see from a more left leaning piece that would state “slightly” but any statement that claims insurance premiums under ObamaCare are anything that remotely resembles reasonable is mind boggling.

Those that have participated on the individual marketplace since before ObamaCare was passed into law have been hit with one rate increase after another beginning soon after the law was passed.  Insures forced to comply with several costly mandates began raising rates just months after the law was passed.  And as insurers become more familiar with the impact the law might have on them in the future, rates on individual plans continued to rise.  Few got away with increases of less than 30% over the period the law was passed and the opening of the ObamaCare exchanges in October of 2013 while others saw their premiums go up as much as 100% as in the case of many Californian’s who were insured by Anthem Blue Cross of California.

And then, to add insult to injury, the majority of those who had been chasing their rate increases over the previous three years were hit again when the ObamaCare exchanges opened.  Few states realized rate increases less than 20% while most saw increases from around 30% on up.  Even with the new taxpayer funded subsidies the administration boasted so much about, most people on the individual marketplace were now paying significantly higher premiums than they would have had the law never passed.  Many were chased right out of having healthcare insurance while a larger percentage required the assistance of the subsidies to maintain the same healthcare coverage that they were once able to afford without assistance.

And for the 30 million or so uninsured that did not qualify for Medicaid, they seem to be disenchanted with the cost of healthcare insurance through the exchanges as well as, even under federal mandate and the threat of penalty, they are simply not signing up for healthcare insurance.

For the 2015 insurance year, rates on the ObamaCare exchanges rose moderately, avoiding skyrocketing increases only because of the risk-corridor provision and pleading by the administration to hold premiums down.  Insurers are guaranteed to be reimbursed for certain losses, those that they did not feel they would be paid back for they passed to plan deductibles.  And the bad news is already out for 2016.  In a recent CBO report it is projected that premiums will increase 8.5% for the coming three years.  This will no doubt drive more people out of the insurance pool than it will attract.

For this claim, we grade the media with a big fat “F”, they did not do any homework what so ever.


And the next paragraph in the article is as laughable is the previous as it provides a complete misinterpretation of the facts:

Early Congressional Budget Office projections showed the law would trim the federal budget deficit by $124 billion from 2010 to 2019, while its repeal would increase the deficit by more than $100 billion from 2013 to 2022. The CBO can't update the law's projected impact on the deficit because of forecasting difficulties.

This statement is made as a result of the findings of a CBO report requested by democrats to score the effects of HR 6079, an ObamaCare repeal bill put forth by House Republicans at the time Romney and Obama were fighting for the presidency in 2012.  The language of the bill reads, and I quote:

"Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period," the CBO and Joint Committee on Taxation said.

It’s a pretty backwards argument to say that repealing a law will reduce spending by $890 billion but because the repeal of the same law that does away with the $1 trillion in revenue it generates its repeal will create a $109 billion deficit {the 1 billion difference is rounding error}.  What this CBO report really reveals, and it was no secrete before this anyway, is that ObamaCare reduces the deficit by generating new revenue, not by reducing federal spending, thus back then making ObamaCare a revenue bill not a reform bill.

But how can this be, didn’t the Supreme Court already rule that ObamaCare was not a revenue bill as if it were it was passed unconstitutionally, or so was the argument?  Revenue bills must originate in the House however, because Democrats lost the final vote they needed to pass the reconciled House/Senate ObamaCare bill, at the suggestion of Nancy Pelosi, the previously passed Senate bill was adopted by the House in its entirety and without change, voted upon and passed. 

Did the Supreme Court get this one wrong and ObamaCare truly is unconstitutional?  It would seem so if Democrats wish to claim that the repeal of the law would create an increase to the deficit as a result of the last revenue generated by ObamaCare.


The next paragraph is more misleading than untrue but misleading has been the means to which this law was passed and continues to survive:

"Most of the dire predictions made by the critics of the ACA have not come to pass," said Drew Altman, president and CEO of the Kaiser Family Foundation.

While it is true that the direst prediction of the law imploding upon itself, made by some of the more extreme ObamaCare opponents, has not come true we must not forget that both the individual mandate and the employer mandate, the two most significant provisions in the law were both delayed.  Had it not been for these delays that law may very well have imploded but more detrimental to the law public popularity of the law would have plummeted when they realized that the uninsured were not showing up to the exchanges {the vast majority of enrollments in 2014 and 2014 were already insured} as well as the devastating effects it was going to have on the employers.

Now, with the thought of over 10 million Medicaid expansion recipients losing healthcare, the center and left of center public are far less likely to even pay attention to the effects either mandate is having on the nation.  Well played Obama, well played, it’s just too bad it was the American people that you played.


The next several paragraphs are benign in nature or refer to the Medicaid expansion, all pretty much on point.  And then there is this:

Over the next decade, the CBO expects the health law to further reduce the number of uninsured Americans by "24 million to 25 million in most years relative to what would have occurred under prior law."

Factually there is nothing wrong with this paragraph, it states what is projected by the latest CBO report however, in the spirit of fair and impartial reporting it would have been nice if the report provided a little perspective as to what this CBO projection refers to and how things are going so far with this projected reduction of the uninsured.

This often stated CBO projected refers to the reduction in the uninsured through the ObamaCare exchanges and does not include the 15-17 million expected to take advantage of the Medicaid expansion.  This very important tidbit of information is rarely if ever included in these reports and creates confusion to the reader who is likely not familiar with what is included in these CBO reports.  Whether or not the reporter leaves this information out due to his or her own apathy or does so intentionally in an effort to mislead the reader we do not know but it is an error regularly repeated. 

And if in fact the author does understand that this CBO projection refers to enrollment through the ObamaCare exchanges, providing some insight as to the current state of enrollment would be quite helpful to the reader.  Currently, enrollment of the uninsured, through the exchanges, totals someplace between 2 and 3 million.  This reflects a 7 million or greater shortfall in enrollment at this point in the game.

We will give this claim a grade of “D” on the assumption that the media found the interpretation of the CBOs findings simply too complicated to understand.


The final two paragraphs of this article put a cap on everything:

As the health care law hits age 5, it's way too early to pass judgment on its effectiveness, said health care blogger Robert Laszewski. The law's main provisions have been in place for only about 18 months, Laszewski said. Marketplace insurers are still being subsidized by the federal government, and only about half of the estimated 22 million marketplace plan members the CBO envisions in coming years have purchased coverage.

"I would rate Obamacare, 18 months after implementation, as incomplete," Laszewski said. "Anybody who wants to look at Obamacare and talk about whether it's a success or a failure, call me in 2017."

First, it cannot go without mentioning the author’s portrayal of Robert Laszewski as merely a “health care blogger”.  I have to assume that Tony Pugh, the well published author of this and many other healthcare industry related pieces, is fully aware of the credential of Mr. Laszewski.  Purposely playing down Mr. Laszewski’s credentials is doing both himself and Mr. Laszewski an injustice as well as is highly misleading to a reader who may not be aware of Mr. Laszewski’s very long list of credentials.

Moving on to the final paragraph, it would have been nice if the author expanded on that Mr. Laszewski was referring to when he was quoted as saying “call me in 2017”.  In the previous paragraph Mr. Laszewski stated that Marketplace insurers are still being subsidized by the federal government.  Laszewski was referring to the risk-corridors provision which insurers are currently taking advantage of, at the request of the Obama Administration, in an effort to hold down 2015 premiums.  They will do the same, to some extent, for 2016 but the risk-corridor provision ends on December 31, 2016 at which point insurers will no longer be protected from losses and will either raise their rates significantly or abandon the exchanges all-together.  Of course an enrollment miracle could change that but I don’t think anyone believes that is going to happen.

We’ll grade these final two paragraphs a “C” as were not false or misleading however the author could have done a much better job at explaining things.

Only 3.3 Million Uninsured Have Obtained Insurance through the ObamaCare Exchanges

The ObamaCare exchanges have performed even worse than I projected, at least so says the Obama Administration.

On Monday, the Department of Health and Human Services (HHS) released its latest enrollment report on ObamaCare.  At first glance, the reported enrollment figure of 16.4 million looked pretty impressive but after taking a second look, it turns out that enrollment through the ObamaCare exchanges has changed little, in fact, if anything these latest numbers reveal enrollment numbers even lower than I previously projected.

The new report indicates that since October of 2013, the time at which the ObamaCare exchanges and the Medicaid expansion opened, 14.1 million individuals gained healthcare coverage.  The report unfortunately does not quantify the make-up of those 14.1 million insurance recipients.  But in another report, issued by HHS less than a month ago, it was stated that as of December 2014, 10.8 million gained healthcare coverage through the Medicaid expansion.

By removing the reported number of individuals who gained Medicaid coverage from the reported total reduction of the uninsured, we arrive at 3.3 million being the maximum number of individuals that could have obtained a qualified healthcare plan both on and off the ObamaCare exchanges.  This falls a half million shy of my earlier projection, I guess I will have to sharpen my pencil a bit.

For simplicity, let us assume that all of these 3.3 million purchased their qualified healthcare plan through the ObamaCare exchanges as the exchanges likely make up the bulk (but not all) of the enrollments.

3.3 million formerly uninsured individuals purchasing a qualified healthcare plan through the ObamaCare exchanges after 9 full months of open enrollment, that’s not much of an endorsement as to the success of a provision in the law which was originally projected to have signed up 10 million uninsured through the ObamaCare exchanges at this point.  This also puts ObamaCare exchange enrollment at a massive deficit heading into the 2016 open enrollment period. 

As sold to congress and the American people, at the close of the 2016 open enrollment period, 13 million individuals were originally projected to have purchased a qualified healthcare plan, as indicated in the March 20, 2010 CBO report issued to then Speaker Nancy Pelosi and presented to the House of Representative just prior to the vote and passage of H.R. 3590, the Patient Protection and Affordable Care Act.  ObamaCare was signed in to law two days later under these terms. 

Does anyone honestly believe 10 million of America’s remaining uninsured are going to have a change of heart and purchase a qualified healthcare plan in 2016?  If the past two years are any indication, fewer than 2 million uninsured will show.

Gaba Confirms ObamaCare Exchange Failure

Anyone that closely follows ObamaCare enrollment is familiar with Charles Gaba and his extensive efforts in compiling ObamaCare enrollment data.  Gaba’s ACASignups.net website has become the go to place for anyone and everyone seeking comprehensive, accurate and verifiable enrollment information.  And so it came with great pleasure that figures shown on his recently released 2015 enrollment graph validated my own efforts in determine the success or failure of the ObamaCare exchanges.

While Gaba’s work is geared towards determining the total number of individuals who gained any form of healthcare coverage as a result of the ObamaCare law, whole or in part, my focus has strictly been on determining the number of uninsured nonelderly that gained a qualified healthcare plan through the state and federal healthcare exchanges as insuring the uninsured is the ultimate goal of the healthcare law or at least so we were told.

From an administration which so often boasts the success of ObamaCare, one would have thought that the efforts Gaba, myself and so many others have taken to get to the bottom of enrollment would be unnecessary especially considering President Obama once claimed his administration would be the most transparent of any.  However, this has proven not to be the case and in regards to providing a breakdown on the make-up of enrollment, there has been nothing short of an information blackout from the Obama Administration both in 2014 and again in 2015.  It stands to reason I guess once you realize how poorly the exchanges have actually performed in insuring the uninsured, the Obama Administration really does hate to broadcast its failures.

At this point in the game some 10 million uninsured nonelderly individuals were expected to have purchased a qualified healthcare plan through the state and federal healthcare exchanges, as projected numerous times by the Congressional Budget Office (CBO), as was accepted as the enrollment goal by the Obama Administration and most important, as used as terms to sell the law to congressional lawmakers and the American people.  Sadly, participation by the uninsured looks to be about one third that.


The Uninsured Don’t Seem to be Interested in ObamaCare

For a very long time I stood alone with my very low prediction in the number of uninsured that ultimately purchased a healthcare plan through the ObamaCare exchanges in 2014.  With each new study released quantifying the nations uninsured population and with each revised report on Medicaid enrollment released by the Department of Health and Human Services (HHS), it became more and more evident that Medicaid enrollees were taking up most of the picture, leaving little room for the uninsured who purchased a healthcare plan.  But nobody was reporting this, at least not the low enrollment figures I was arriving at.

For 2015, with HHS providing weekly enrollment reports for the federal healthcare exchange, along with data collected from various other reliable industry sources, I attempted to project how effective the ObamaCare exchanges were in attracting America’s uninsured population.  I posted my final projections in an earlier blog dated February 25th.  As stated in the blog, for 2014 the ObamaCare exchanges appear to have attracted a mere 1.4 million uninsured enrollees while 2015 fared better with an uninsured enrollment of 2.3 million.

Of course, me being an unknown entity, my projections have come under great scrutiny by many low information proponents of ObamaCare too apathetic to do a little research and some basic math in fear of proving themselves wrong.  But those who have called my projections into question have been put in check as I am no longer that lone wolf out their touting the failure of the ObamaCare exchanges, I now have the ultimate ObamaCare enrollment support group, Charles Gaba and his graphs!

Now let me be clear, I am not implying that Charles Gaba has endorsed my little know blog, my opinion or my findings, it’s not likely that Gaba has even the slightest inkling as to who I am.  However, in his highly accepted reporting of enrollment, he has provided what is a very rare commodity, the actual reporting of the number of uninsured that have participated on the healthcare exchanges.

From Gaba’s website in regards to his enrollment findings:

“However, now that every state (except for Idaho) has been updated through at least February 15th, here, once again, is the complete 2015 ACA enrollment graph, showing the rough breakout of all 32.3 million people whose current healthcare coverage is either wholly or partly due specifically to the Affordable Care Act.

Again, that does not mean that all 32.3 million were uninsured to begin with. By my best estimates based on the available data, I estimate that around 19 million already had some form of insurance coverage. Around 11 million were uninsured prior to January 2014, and around another 2 million were uninsured prior to January 2015.”

In 2014, of the 11 million reduction of the uninsured reported by Gaba, 9.5 million are true Medicaid enrollments directly linked to the Medicaid expansion, as depicted in his graph.  This leaves no more than 1.5 million possible uninsured enrollments through the ObamaCare exchanges during the 2014 open enrollment period which is in close agreement to the 1.4 million enrollment figure I arrived at.

For 2015, Gaba states that another 2 million of those who now have healthcare insurance were uninsured prior to January 2015.  This too is not far off from my more generous prediction of 2.3 million.

Gaba and I did not reach our conclusions using the same method which brings increased validity to these numbers. 

My method was quite simplistic and for 2014 I used nothing more than a study from a well-respected industry source as my baseline for the reduction in the nations uninsured and subtracted the number of those taking advantage of the Medicaid expansion over the same period, as reported by HHS.  The difference is the maximum possible number of uninsured that could have purchase a qualified healthcare plan through the ObamaCare exchanges.  It does not take in to account any off exchange enrollment which would drive the figure down even lower.

For 2015 I compiled HHS weekly enrollment reports along with a little internet research to estimate the number of transfers to the ObamaCare exchanges from other marketplaces.  My method for both years is better explained in an earlier blog post of mine. 

Gaba on the other hand amasses tons of enrollment data from numerous sources to create his data table.  Gaba’s method is significantly more accurate but when dealing with figures well into the millions, being off by a few thousand is not enough to change the argument.

Two very different and verifiable methods both conclude that after two open enrollment periods (9 full months plus extensions) and from a pool of 40 million uninsured nonelderly Americans eligible to purchase healthcare plans through the ObamaCare exchanges, significantly fewer than 4 million chose to do so.  You can draw your own conclusions as to the effectiveness of the ObamaCare exchanges in attracting the uninsured.

Is ObamaCare Fulfilling Its Intended Purpose?

If you are a proponent of ObamaCare then you are likely to stand by the claim that ObamaCare is working great and helping millions of people and in some regards you would be right.  Certainly the Medicaid expansion has helped millions gain the security of healthcare coverage but honestly, how hard is it get people to sign up for something when it is FREE, especially when that FREE is someone else paying the tab on your healthcare!  The Medicaid expansion can hardly be used as a measure of the success for the massive healthcare law much less deem it a major accomplishment as again it is FREE to the end user!

Beyond the Medicaid expansion there is little else that has gone well for ObamaCare.

Insuring the Uninsured Nonelderly  -  As we have already ascertained, enrollment of the uninsured nonelderly through the ObamaCare exchanges has missed its mark nearly threefold and there is every reason to expect future enrollment to get worse instead of better.  As premiums and deductibles continued to rise, the pool of interested uninsured participants shrinks. 

Overall, participation on the ObamaCare exchanges will increase significantly in the coming enrollment periods as more employers terminate the healthcare relationship with their employees the majority of which will likely transfer over to the ObamaCare exchanges in search of taxpayer funded subsidies.  But as for the uninsured, they will continue to be a scarce commodity.

Reducing HealthCare Premiums  -  Despite all the signs of increased premiums heading our way back in 2013, President Obama remained adamant that his signature healthcare law would lower premiums on the individual marketplace.  And it was on the eve of the rollout of the HealthCare.gov website that he took a victory lap while exclaiming “See, ObamaCare Works”, this happening shortly after the Governor of New York released the insurance rates that would be offered on their state run exchange.

The liberal media was all over the story of the 40% rate reduction in New York while they ignored reporting on the reality that was faced the next morning, a reality that industry experts such as the Manhattan Institute had been reporting on during the months, weeks and even days leading up to the rollout.  While New Yorkers were elated to finally be able to afford healthcare insurance, residence in 43 other states (including DC) woke up to a very different reality.  In each of those 43 states insurance premiums offered on the ObamaCare exchanges increased on average, compared to the previous years rates on the individual healthcare insurance marketplace.  36 of those states realized an increase of 20% or greater, six of which had an average rate increase of over 80%. 

The Obama Administration’s response to these near nation-wide rate increases was at the very least pathetic.  Sweeping over the fact that the law failed to reduce individual insurance premiums as promised, the administration’s reply to the question was that with subsidies, most would still see a reduction in their insurance premiums.  This gave little comfort to the millions whose insurance policies were canceled and ended up paying more through the ObamaCare exchanges, even after subsidies.  As well this provided little comfort to those picking up the tab.  This was neither the plan nor the promise made by the Obama Administration and Democratic Lawmakers who forced this law upon the American people.   

So why did the State of New York experience such a rate reduction windfall while all others did not?  The answer is simple, New York and a very broken healthcare system due to decades of overregulation and attempts to do the very same thing the ObamaCare law is now attempting to do nation-wide.  Similar to how RomneyCare worked well in fixing the broken healthcare system in the State of Massachusetts, the ObamaCare model was well suited to address the problems faced by the State of New York’s broken healthcare system.  Unfortunately this one-size-fits-all approach is not suited for the balance of the states which were not suffering from the same overregulation and out of control rate issues as New York and a small handful of other states. 

And let us not forget that before ObamaCare came into existence, healthcare insurance on the individual marketplace was affordable to most working Americans even without subsidies.  What have we really accomplished here?

Slowing the Growth Rate of Healthcare Costs  -  When President Obama speaks of the slowing in the growth rate of healthcare cost, listen closely to what he says or more important, what he does not say.  At no time does the president ever tie the slowing growth rate of healthcare costs to his signature healthcare law although the subject is always brought up when he is touting the law’s success.

There is no denying that the growth rate in healthcare costs has slowed however, this is a trend that started in 2009 and before ObamaCare was a bill much less a law.  Economist and industry experts, including the CMS actuary, contribute most if not all of the slowdown in growth to the 2007/2008 recession and slow economic recovery.  As well, they expect growth to return to its previous rate once the economy returns to normal as ObamaCare has done little to reform the actual cost of healthcare. 

In a nutshell, ObamaCare has done nothing measurable that can attribute to the slowdown in the rise of healthcare costs and the president never actually states that it does.

Insuring Those With Pre-Existing Conditions  -  One of the grandest lies perpetrated by the sellers of ObamaCare was that the law would ensure that millions who have been denied affordable healthcare due to a pre-existing medical condition would no longer be discriminated against.  Millions, what millions?

In an attempt to mislead the American people as to the severity of the pre-exiting condition issue facing or nation, then HHS Secretary Kathleen Sebelius and the president publically stated that without healthcare reform 129 million people with a pre-existing medical condition could be denied affordable {healthcare} coverage, a claim also published in an report issued by HHS.  Of course democrats ran wild with this claim and used it to demonize those heartless republicans who opposed the law. 

There is no question that for decades private healthcare insurers have denied coverage to many with high cost/high risk medical conditions but for the administration to insinuate that there are millions or even potentially millions of people with a pre-existing condition that could suffer without healthcare reform is nothing short of a fairy tale  And to support the fairy tale claim, when the High Risk Pool provision, better known as the Pre-Existing Condition Insurance Plan or  PCIP, of ObamaCare was created, CMS Chief Actuary reported that only 375,000 people would enroll in this provision.  What happened to all those millions?

Only those with their heads buried three feet in the sand actually believed that 129 million people could be affected by the new healthcare law, most did believe the number to be well into the millions however, as that is what was repeatedly told to them since the day Obama was sworn into office.  But the real kicker is, of the 375,000 estimated to be in need of assistance through the federal PCIP provision, as stated the CMS Chief Actuary, ObamaCare managed to attract fewer than 135,000 participants across all 50 states and DC over the three and a half years the federal PCIP program was in play.   

During the first year the federal PCIP was made available, fewer than 50,000 individuals enrolled on the program and by the end of 2013, enrollment increased to just under 135,000.

So why so few enrollees, did CMS get it wrong?  Likely not, at least not in regards to enrollment estimates, but they did get the cost wrong.  As it turns out, there was little affordability provided in the federal PCIP and therefore nearly two thirds of the projected enrollees remained lock out just as they had been in the past, they simply could not afford the insurance being offered to them.  In addition to the high buy in cost of the federal PCIP, the administration grossly underestimated the overall cost to cover the medical needs of those who did enroll.  With barely over one third the projected enrollment the federal PCIP still ran through its entire budget and actually cut off enrollment early to prevent having to ask congress for more money.

It is hard to fathom that the Obama Administration wasted so much time, energy and American tax dollars creating the unaffordable Affordable Care Act which continues to leave the very people it was intended to help, out in the cold.  And let us not forget that the combined enrollment of the state and federal PCIP programs numbered in the hundreds of thousands not tens of millions as the Obama Administration wished us all to believe.
 

ObamaCare is clearly missing all of its marks.  So despite all the claims of greatness and the continued rhetoric from the left against those who oppose the law, the president’s legacy legislation has turned out to be nothing more than an extremely costly expansion of the Medicaid system which has unnecessarily transformed the private insurance industry and has driven affordability so far out of individual healthcare plans that even under federal mandate and massive fines, the uninsured still reject the law. 

Based on the long list of ObamaCare failures, any congressional lawmaker that possesses an ounce of moral fabric, any degree of fiscal responsibility and claims that he or she is looking out for the overall best interest of the American people should be screaming at the top of their lungs to repeal this law.  And judging from all the laws shortcomings, I think it is safe to say that any alternative to ObamaCare would be a marked improvement.

ObamaCare Enrollment Fails to Attract the Uninsured Once Again

It has been just over a week now since the ObamaCare exchanges 2015 open enrollment period closed and nary a word has been heard from neither the Obama Administration nor the news media, even the report that 11.4 million individuals selected a healthcare plan through the state and federal exchanges lasted no more than a day in the news cycle.

So why all the quiet?  According to the Department of Health and Human Services (HHS) report, enrollment far surpassed their projection of 9.1 to 9.9 million.  Even with the expected attrition rate enrollment should still end up someplace in the mid 9 million range.  Shouldn’t the Obama Administration be jubilant over this?

Maybe the hush hush from the administration is due to the fact that for the second year since their opening, the ObamaCare exchanges have fallen far short of their intended purpose.


The Purpose of ObamaCare

The intended purpose of ObamaCare was to make healthcare insurance both affordable and accessible to the uninsured and by doing so it would attract millions who have for years found healthcare insurance unobtainable, at least that was the plan.  But if that didn’t work, the new law imposed a federal mandate requiring all individuals to have healthcare insurance or face a penalty.

To accomplish this, ObamaCare created two avenues through which the uninsured could gain access to affordable healthcare.  For the lowest income earners, an expansion of the Medicaid system brought them access to free healthcare services.  And for those with incomes above the Medicaid threshold, government managed healthcare exchanges were formed through which taxpayer subsidized, private insurer provided healthcare plans could be purchased.

Of course, the Medicaid expansion provision of ObamaCare is working great, maybe even too great for some states which are now facing budgetary issues as a result of higher than anticipated participation.  And why shouldn’t the Medicaid expansion be working great, it provides fully taxpayer funded healthcare for the very low income.  It’s pretty hard to beat FREE!

The healthcare exchanges on the other hand, are not fairing as well in their effort to attract the uninsured.  Why are the exchanges experiencing difficulties?  There are two primary reasons the first being quite simple, affordability. 

The number one mission of ObamaCare was to drive affordability into the individual healthcare insurance market but it failed to do so in epic proportion.  The new law transformed how private insurers packaged and rated their healthcare plans through a mountain of new regulations and mandates.  There were some minor reforms put in place but nothing close to what was needed to offset the cost of the new regulations and mandates now being imposed on individual insurance plans much less enough to lower rates.

Instead, the new mandates drove individual insurance plan rates up substantially in virtually every state as the nation saw firsthand when the healthcare exchanges first opened back in October of 2013.  Even with tax subsidies, only the lowest income qualifiers receive any substantial savings. The exchanges did make affordable healthcare available to those who were previously denied coverage by private insurers however, this accounts for a very small fraction of the uninsured in this country.

The second and far less talked about reason the exchanges have failed to attract the uninsured is the fact that many of the nations uninsured simply are not interested in obtaining healthcare insurance.  It was naïve for the Obama Administration to think that millions of people who have historically chosen to be uninsured were going to have a change of heart.  Failing to bring affordability to healthcare gave even less incentive for this particular group of individuals to get in line and sign up.


What Where the Enrollment Goals?

All we hear from the liberal media today is that the ObamaCare exchanges have met their enrollment goals, but have they?  It all depends and what you believe the goal is!

Was it the goal of the ObamaCare exchanges to merely transfer millions of insured individuals from one marketplace to the ObamaCare exchanges or was it the goal of the ObamaCare exchanges to play a major role in lowering the number of this nation’s uninsured population?  It was the latter of course although this certainly is not being promoted by the Obama Administration.  And the administration’s silence on the intended goals of the ObamaCare exchanges is for good reason as they have missed their mark by a huge margin.

So what were the goals of the ObamaCare exchanges exactly?

At the request of then Speak of the House Nancy Pelosi, the Congressional Budget Office (CBO) performed a study regarding the projected effects of H.R. 3590 PPACA.  The study projected that in 2014, the number of the nation’s uninsured would be reduced by 6 million as a direct result of enrollment through the ObamaCare exchanges.  For the following year (2015) the study projected the reduction would increase to 10 million and by 2016 16 million Americans were projected to have purchased and maintained a qualified healthcare plan through the ObamaCare exchanges.  The following day that this CBO report was released, the House voted on H.R. 3590 PPACA which passed without a single republican vote.  Just 2 days later, ObamaCare was signed into law.

Exactly one year later the CBO released another study which included the projected effect of the ObamaCare exchanges.  The report was submitted as testimony in a March 20, 2011 hearing conducted before the Subcommittee on Health Committee on Energy and Commerce U.S. House of Representative.  This CBO report revealed the same projections for the reduction of the uninsured through the ObamaCare exchanges as did the CBO report of one year prior.  There were many other CBO reports on the effect that ObamaCare would have on the uninsured population released during the crafting of the law, all of which provided similar results.

More recent CBO studies have lowered the projected effect of the ObamaCare exchange on the nation’s uninsured population slightly however, the figures state above are the enrollment projections use to sell the law to Democratic Lawmakers who voted for the law as well these are the enrollment figures that the law is expected to achieve by those who have been stuck picking up the tab.

Just How Bad Have the ObamaCare Exchanges Fail?

Overshadowed by the attention generated by the massive failures of the HealthCare.gov website, the first round of ObamaCare open enrollment has been largely forgotten.  Nearing the end of the enrollment period and fearing major public and political backlash from what appeared to be horribly low enrollment, the Obama Administration lowered expectations from 7 million down to 6 million.  But with the bandaids applied to the website and a surge in last minute enrollment, at the closing bell it appeared that some 8 million individuals had selected a healthcare plan through the state and federal exchanges during the 2014 open enrollment period.

Over the following year those 8 million selected plans slowly dwindled down to 6.7 million enrollments, just short of the original enrollment projection however, no report has ever been released by the administration which identifies exactly how many of those enrollments were made by the formerly uninsured.  Republican Lawmakers and watchdog groups have tried and tried again to get the Obama Administration to release a breakdown of the 2014 enrollment figures but transparency not being this administration’s strong suite, they have failed to do so to this day.  But there is always more than one way to skin a cat!

The Urban Institute conducted a study that looked at the effects of the ObamaCare during its first year of implementation.  What the study revealed was that at the end of the first year 10.6 fewer American’s were uninsured.  The report also went on to state that the most of the gains in reducing the number of uninsured were made through the Medicaid expansion which a report released by the Centers for Medicare andMedicaid Services (CMS) quantifies as 9.2 million during the same period.   The net, 1.4 million, is the reduction in the uninsured through the purchase of a qualified healthcare plan during the first year the law was fully implemented, not all of which were purchased through one of the ObamaCare exchanges it must be noted.

The 2015 open enrollment period did better at attracting the uninsured than did the 2014 open enrollment period although the numbers are still terrible.  Let’s take a look.

2015 Open Enrollment by the Numbers:

            Total plans selected                            11.7 million
            Renewals                                             5.9 million
            Attrition                                              1.0 million
            Known Transfers                                2.5 million
            Reduction in Uninsured                   2.3 million

The total plans selected reported here differs slightly from the 11.4 million that HHS announced to the media.  This figure is based on the weekly enrollment on the federally managed exchange which HHS reported in their weekly blog and expanded to represent 100% of exchange enrollment.  The same method was used for renewals which were also reported by HHS in their weekly blog enrollment updates. 

New enrollment attrition, i.e. those who will never pay for the plans they selected or will cancel their plans within the first few months is a projection based on a loss of 17% of the non-renewal plans selected, the new enrollment attrition rate of 2014 enrollment. 

Know transfers are the sum of 2015 employer healthcare cancelations, 2015 private policy cancelations, late renewals and state exchange closure transfers.  What is missing from the know transfer figure is the number of off-exchange non-cancelation transfers that took place as there is no accurate method to determine this figure.

When all the figures are tallied up, 2.3 million enrollments remain which is the maximum number of individuals who could have obtained a qualified healthcare plan through the state and federal exchanges during the 2015 open enrollment period.


ObamaCare is Losing Customers

Almost as troubling as the low turnout by the uninsured in 2015 is the prediction that 1.2 million 2014 ObamaCare enrollees would likely not renew their plans in 2015.  This admission was made in a brief issued by HHS (ASPE) just days before the open enrollment period began.  In the brief HHS made reference to industry information regarding insurance marketplace retention rates being between 80-85% and predicted the same for the 2014 ObamaCare exchange enrollment. 

The problem with this prediction is that in the pre-ObamaCare marketplace the 15% lost  enrollment of one insurer becomes a 15% gain by another insurer whose loss moves to another and so on and so forth.  In the case of ObamaCare however, the ObamaCare exchanges are the last stop for those seeking out the most cost effective healthcare plans as only through the exchanges can the vital cost saving tax subsidies be obtained.  With 87% of those enrolled through the exchanges receiving subsidies, those leaving ObamaCare are not doing so because they found a more affordable plan.  More likely those leaving the ObamaCare exchanges are doing so as even with subsidies, healthcare insurance has still been found to be too costly.  There are also certain number of individuals ending their subsidized coverage and transitioning to employer provided insurance plans.

The argument of normal attrition, made by HHS, to account for enrollment losses they predicted to suffer in 2015 is little more than a smoke screen raised in an effort to try and explain away the losses caused by other variables such as high premiums and deductibles.  But if it is any consolation, renewals appear to have been better than HHS projected with 5.9 million of the 6.7 million 2014 enrollment returning.  That equates to a net loss of 0.8 million versus the 1.2 million HHS projected prior to the open enrollment period beginning.

   
To summarize, fewer than 1.4 million uninsured Americans purchased a healthcare plan through the ObamaCare exchanges during the 2014 open enrollment period and an additional 2.3 million did so in 2015 making the total reduction of the uninsured through the ObamaCare exchanges a whopping 3.4 million to date.  This figure is significantly short of the 10 million that was originally projected when selling the bill to congressional lawmakers back in 2010.  And with the loss of 0.8 million re-enrollees in 2015, at least a portion of which are a direct result of the ObamaCare exchanges, the reduction in the number of the nation’s uninsured through the exchanges likely lingers around the 3 million mark as we enter our second full year of ObamaCare.

The uninsured seem unimpressed with the offerings made to them through the ObamaCare exchange and even under federal mandate and the threat of penalty seem to be disenchanted with the whole idea of ObamaCare!