Xpostfactoid saves me the trouble of addressing the "ACA needs to retain 8M to reach 13M" factor
2019 OPEN ENROLLMENT ENDS (most states)
Time: D H M S
The New York Times has an story this morning about the challenges facing the ACA exchanges as they head into Year Two of Open Enrollment. For the most part it's pretty good, but there's one bit of flawed reasoning which caught my eye. I was planning on writing an extensive response, but Xpostfactoid (whom anyone who visits this site regularly should also be reading) beat me to the punch:
No one can or will try to ensure eight million renewals, because a very large proportion of 2014's enrollees -- perhaps half or more -- will not need to renew their coverage. They will be covered by new employers, or new spouses, or newly employed old spouses, or they will lose income and become eligible for Medicaid, or they will go on disability, or die, or, or, or...
Read his whole piece. I'm only posting anything here in the hopes of gaining some exposure for his analysis.
The only thing I'll add is that, while we won't know the specific reason for most of those who drop their ACA coverage, as I've noted before, around 200,000 of the original 8.02 million likely were 64 years old last year and turned 65 at some point this year, moving onto Medicare.
I should also note that rightly or not, "13 Million in 2015" seems to have become the "...Or Bust!" number of private QHP enrollments to reach the 2nd time around. I'll say it here and now (not for the last time, not that anyone is likely to listen): Neither the "7 million" figure from last year nor "13 million" this year are "pass/fail" targets. The ACA isn't going to collapse into ruin if the number next year ends up being, say, 11 or 12 million instead of 13, just as it wouldn't have been a failure if it had only hit 5 or 6 million this year. The CBO was just projecting what they thought was likely to happen, not what they felt was necessary for success.
Former HHS Secretary Kathleen Sebelius was largely responsible for the "7M or bust" meme by answering the question "What does success look like?" by responding "At least 7 million people having signed up by the end of March, 2014." That doesn't necessarily mean that any number lower than 7M would have been a failure. Think of it this way: If I won $50 million in the lottery, I'd define myself as "rich". However, if I won $5 million in the lottery, I'd also define myself as "rich".
However, people like targets, and I've been just as big a part of promoting that as anyone, so be it: 13 is the new 7.