All told, 364,682 people in two months selected an insurer using the federal and state exchanges created by the Patient Protection and Affordable Care Act, according to a government report today. An additional 803,077 were found eligible for state children’s health plans or Medicaid, the program for the poor being expanded in at least 26 states next year.
Hey so finally numbers are looking decent for Obamacare enrollment. In particular, 800,000 people getting access to children’s plans and Medicaid is awesome news.
The private sector number is way behind where the government was hoping they’d be by this point (1.2 million buying insurance coverage from a private company, rather than 365,000). This is probably not great news in terms of avoiding the “death spiral” where only the people who need medical care in the immediate future sign up for coverage. Insofar as this system is set up to coddle private insurance companies and guarantee them steady profit, this is always going to be a risk with the private insurance mandate.
So why aren’t people signing up? Definitely there is a pool of people for whom health insurance is unambiguously too expensive at current prices. But that still leaves millions of people unaccounted for who would clearly benefit from insurance but haven’t signed up for it. What are they doing? Three possibilities:
They’re waiting until the website is functional. When you see tons of stories in the news about delays and mistakes in online registration, and then tons of stories about the government making massive investments in improving the online registration system, and you can’t actually get coverage until January, it makes sense to hold off until December, right? This is the most optimistic scenario, because it suggests that the problem will correct itself in next month’s numbers.
They don’t trust insurers. Historically health insurers have done everything they can do avoid reimbursing patients (e.g. labelling medical problems as “pre-existing”) and used confusing terminology and other obfuscation to take money and not provide coverage. New regulations are supposed to prevent this, but it might take a couple years before people are willing to trust insurers enough to fork over thousands of dollars per year to them for an unknown quality and quantity of coverage.
They can’t afford the payments. Plenty of people make too much to qualify for subsidies but can’t necessarily afford to spend thousands of dollars on health insurance - especially if, say, they’re also making mortgage and student loan payments. In this situation, people might think it makes sense to sign up only if they are diagnosed with a chronic medical condition and otherwise hope to avoid accidents. This is by far the worst situation (the “death spiral” where rates rise and fewer non-chronically-ill people sign up) because basically the government either needs to introduce a public option or broaden subsidies or allow insurance companies to stop covering new chronically ill patients.
Anyway yeah it looks like at least the system is avoiding the kind of total disaster where no one signs up at all. But enrollment is well below goals and it’s still not clear why. Hopefully next month’s numbers will give more context.
They are of course correct — linkbait headlines alone can’t make people share good content. However, they are disingenuous — the headlines *do* make people click on things once shared, so Upworthy shares convert much better than others. There’s a reason they spend so much time on their headlines.