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The Health Care Numbers Are Out, And They're Disappointing

Posted: November 13, 2013

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Just over 100,000 people managed to get signed up for health insurance through the state and federal health exchanges, the Obama administration reported. But barely a quarter of those — 26,794 — signed up through the faltering HealthCare.gov website.

The Obama administration released its much anticipated enrollment numbers for the first month of the troubled HealthCare.gov website Wednesday. And as predicted, the numbers were disappointing.

Just over 100,000 people managed to navigate the process and choose a health plan between Oct. 1 and Nov. 2 — 106,185 people, to be precise.

But barely a quarter of those, 26,794, enrolled through the federal website that's signing up people in 36 of the states. The rest enrolled through state marketplaces.

Earlier this week, people were leaking numbers that suggested that the number who enrolled via the federal exchange was about 40,000; 26,794 is even lower than that. On the other hand, what it really tells us is that the HealthCare.gov website wasn't working, so people couldn't choose a plan. That's not exactly breaking news.

On the state side, some states have been reporting their enrollment numbers all along. The one state we hadn't heard from was California. On Wednesday, federal officials reported that 35,000 people had enrolled in California — nearly half of the 76,391 total for the 11 states included in this report.

Questions remain, of course, including exactly what the administration is counting in these numbers.

In order to be formally counted as enrolled in a health plan, at least by an insurance company, you have to pay the first month's premium. But coverage doesn't begin until Jan. 1 at the earliest. Very few people are going to sign up in October and front out money three months in advance. So the administration is counting what are being called "shopping cart" people. They are those who have completed the enrollment process and chosen a plan but have not necessarily paid their first month's premium.

We now know that a lot of people are qualifying for Medicaid coverage or the Children's Health Insurance Program; 396,261 people have been deemed eligible for these programs so far. About 213,000 have enrolled through the state exchanges, and 183,000 on the federal exchange.

That's probably because in some states there was a big outreach effort to find people eligible for Medicaid or children's insurance. Also, the part of the state and federal exchanges that determines eligibility for Medicaid was working pretty well in October, compared with the part on the federal website that determines subsidies.

Just about every health care analyst points out that you shouldn't expect a lot of people to sign up during the first month of a six-month sign-up period. So the numbers probably would have been pretty small even if everything had been working just fine.

What this does tell us, however, is that there will be more pressure on the system, particularly the federal website, as we go forward. That's especially true if there's a surge of people who want to have insurance that begins Jan. 1. They have to sign up by Dec. 15.

And if that website isn't working as promised by the end of this month — or even if it is — there could be a huge demand that could very well overwhelm the system.

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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