Thursday, January 05, 2017

Flatline

Yesterday - with little fanfare - HHS released the Obamacare enrollment snapshot from week 9. This release is for the Federal exchange (healthcare.gov) from November 1st through December 31st and includes all plan selections (not paid plans) effective for January 1st as well as those who selected plans after December 15th that will be effective February 1st.

Other than a Sylvia Burwell tweet this uninspiring report got very little media attention (a Google search confirms it). This is because the numbers just aren't good. Compared to last year the increase in plan selections is a mere 154,123. Worse yet, all of the growth is attributed to renewals. New enrollment is down by more than 350,000 from last year.

That statistic should be troubling to ACA supporters. With a little over a month remaining in OE4 the prospects of hitting enrollment targets is next to impossible. Even when factoring in the state based exchanges there would need to be another 2 million or so NEW enrollments to hit the revised numbers.

There is little reason to rejoice in Obamaville this year. The signature achievement is showing its true colors to a much broader swath of the general population at a much higher cost than we were promised. Medicaid expansion is way over budget and will soon be costing states who expended billions in additional cost. Premiums are up significantly in the individual market, insurer participation is down, provider networks are razor thin, and benefits like deductibles are rising to unattainable levels. In the near future employer plans will also take a hit negatively impacting wages and benefits for middle class workers.

If the new Congress and President elect are smart (which is questionable) they would begin pointing out these flaws immediately. The narrative needs to be changed from an emotional viewpoint (see #makeamericasickagain) to a financial and practical viewpoint.

Then again, when has the Fantasyland known as Washington DC ever been fiscally responsible or practical? When one can only get reelected by playing on our emotions the answer is never.
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