Get ready for the next attack on the enrollment numbers...

Hat Tip To: 
Glenn Kessler

OK, this one is actually semi-legitimate, depending on your perspective.

According to Glenn Kessler of the WaPo, when the CBO crunches the numbers next year to see how many 2014 ACA Exchange QHPs actually did qualify as being counted towards their 7M (then 6M) projection, they're actually going to have to slice up every single person enrolled into 12ths.

That is to say, if your policy started coverage in January and was paid for straight through until the end of the year, you'll be counted as one "CBO person", but if it didn't start coverage until, say, April 1st, you'd only be counted for 9 months, making you 3/4 of a "person" in CBO terms.

Needless to say, not only does this complicate matters considerably, it also means that when the CBO releases their full-year 2014 report next year (January? February?), it may look something like the following:

  • Jan-start: 10/01/13 - 12/31/13: appx. 2,251,000
  • Feb-start: 12/29/13 - 01/15/14: appx. 524,000
  • Mar-start: 01/16/14 - 02/15/14: appx. 996,000
  • Apr-start: 02/16/14 - 03/15/14: appx. 1,353,000
  • May-start: 03/16/14 - 04/15/14: appx. 1,976,000, plus however many enroll by 4/15...I'm assuming around 1 million at the moment, or 2.976M total

So, out of an expected 8.3 million enrollments, assuming my estimated 93% total payment rate and assuming that all of those 93% stick with their policies through the end of the year (or at least that those who don't are replaced by other new enrollees who are), we get:

  • Jan-start: 2.251M x 12/12 = 2.251M
  • Feb-start: 524K x 11/12 = 480.3K
  • Mar-start: 996K x 10/12 = 830K
  • Apr-start: 1.353M x 9/12 = 1.015M
  • May-start: 2.976M x 8/12 = 1.984M

Add them all up and you'd get around 6.6 million "people-years" total, x 0.93 = 6.14 million fully paid for every month from their start date until 12/31/14.

Of course, not all of these people will stay on their exchange QHP, while others will be added via Major Life Events (births, divorces, marriages, job gain, job loss, etc). I think it's safe to assume that this "baseline churn" will probably result in new enrollments cancelling out those leaving the exchanges.

So, assuming Kessler is correct about this "1/12" granularity by the CBO, it's possible that the official report will state that only around 6.1M people end up "fully counted" towards the projection...missing the 7M mark but still clearing the lowered 6M mark.

Don't get me wrong--the CBO is correct to track things with this level of granularity (I just didn't know they'd be able to do so with that much detail...talk about a herculean task!), as it does have significance in terms of the impact on the federal budget, which is their primary focus.

However, politically, it's insane to try and use this to claim that "interest is low" or "no one wants Obamacare" and so forth. Those lines around the block in El Paso, Texas and Las Vegas, Nevada were no fluke: Those people wanted to get health insurance.

No doubt the GOP will continue to hoot and holler about President Obama "lying" or "cooking the books" and so forth, but that's absurd. If that's the criteria that has to be met before declaring that someone has "fully enrolled", then the answer would be zero, because they'd claim that we have to wait until 2015 before we're allowed to count a single person. Which, of course, is exactly what they're gonna argue.

That's insane, but that's also the political climate we're living in today.