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!

ObamaCare Fails its Primary Objective!

If the Affordable Care Act is as successful as President Obama insists it is then why does his administration still refuse to release an enrollment figure for the number of qualified healthcare plans sold to the long term uninsured through the state and federal healthcare exchanges?

HHS Secretary Sylvia Burwell is all too eager to boast the number of low income individuals who have taken advantage of FREE Medicaid through the expansion put forth in the ObamaCare law.  However, since their launch back in October of 2013, not once has this administration made available to the public the number of long term uninsured individuals who purchased a healthcare plan through one of state and federal healthcare exchanges.  In fact, the folks over at HHS has taken painstaking measure to ensure that this figure could not be sifted out of other enrollment data that they make public.

At the passage of the president’s namesake healthcare reform law, the size of the pool of the uninsured individuals who were qualified to purchase a healthcare plan through the healthcare exchanges was double the size of those who qualified for the Medicaid expansion.  Yet, due to embarrassingly low enrollment figures, the Obama Administration all but denies that this large group of uninsured individuals even exists.  You will not hear anyone in the Obama Administration speak of this sub-set of the uninsured and the number of long term uninsured individuals who have purchase a healthcare plan  through the state and federal healthcare exchanges is a number the administration will certainly not put in writing.  Insuring this large group of uninsured individuals is the primary objective of the entire healthcare law, making healthcare insurance attractive enough for them to do so has been the laws greatest failure.

At the current rate of enrollment, by the end of the decade the healthcare exchanges will fall no less than 14 million short of their original 24 million enrollment goal.  This will raise the number of individuals left uninsured from the Obama Administrations projection of 30 million to over 44 million.
 
And Democrats dare to call this a success?

With such a massive failure of the key provision in the law, one would think that Democrats would be the ones in the front of the line calling for its repeal and replacement.  It’s there law and it has done significantly more harm than it has done good and has no chance of ever improving.

The ObamaCare Exchanges!

 

The Original Plan

To insure 13 million of America’s long term uninsured nonelderly by 2015 and 24 million by 2017.

Source:  CBO’s May 2013 Estimate of the Effects of the ACA

Where We Stand Today

Fewer than 3 million of America’s long term uninsured nonelderly have purchased a qualified healthcare plan through the ObamaCare exchanges putting enrollment on a trajectory of fewer than 10 million likely to purchase a healthcare plan through the exchanges by 2017.  This would increase the administrations projection of the number of Americans who would remain uninsured from 30 million to more than 44 million by the end of the decade.


And Democrats call this success?


On a positive note, the Medicaid expansion has not presented itself as too much of a challenge for the Obama Administration.  In fact, giving away FREE Medicaid has gone so well that a growing number of states, where Medicaid expansion enrollment has exceeded projection, are finding themselves in a financial pinch.  These states will have to come up with some other means to cover the unexpected cost of the expansion, such as raising taxes or cutting spending on education and other services.

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.