Don’t Panic

11.13.13

First Obamacare Enrollment Numbers Are Dismal, but It’s No Failure Yet

Just 106,856 Americans have chosen plans, when the prediction was 500,000? That’s bleak, but worse would be a crippling of the exchanges by panicked Democrats to guarantee failure.

On Wednesday afternoon, the Obama administration released an avalanche of numbers (PDF) detailing the progress of HealthCare.gov and enrollment in the exchanges. Compared to the pre-launch prediction of 500,000 private enrollees in the first month, the news is disappointing.

Just 106,856 Americans have chosen plans in the exchanges. Of those, 79,000 did so through state exchanges and 26,794 through the federal website. Nearly half of all sign-ups were in California and New York, which—not coincidentally—are two of the states that have worked hardest to build exchanges and implement key parts of the law. Overall, 82 percent of all enrollees came from blue states, a testament to the stark divide between states that support the law and states that oppose it. Only one red state has its own exchange: Kentucky. So far, it’s enrolled 5,586 people.

It’s important to note that the administration has tried repeatedly to manage expectations for enrollment, often citing the example of Massachusetts, which had few enrollments at the beginning of its health-care rollout in February 2007. By the end of the year, however, participation had spiked, with 36,000 enrollments of 80,000 eligible uninsured people. And of those, 20 percent purchased coverage in the last month before the penalty kicked in.

If Americans follow the same pattern with Obamacare, then we should see a mass of enrollees near April, when enrollment ends. According to the administration, there have already been 26.8 million visits to state and federal websites and 3.1 million calls to call-in centers asking about coverage. In addition, of the 1.5 million people who have applied for coverage, 1.48 million have received an eligibility determination. In other words, if you make it to the application stage of the exchanges, you will find out if you’re eligible for a subsidy. And on that note, more than 846,000 individuals have completed applications, though—obviously—they haven’t made the purchase. Whether any of that is successful, though, depends on whether the website can be fixed. The Washington Post reports that the end of the month deadline for repairs might be breached, but the administration says it is making headway.

Looking forward, the report offers a mixed bag. On one hand, the initial numbers are dismal, and—when combined with the botched rollout, mass cancellations on the individual market, and questions about the president’s honesty—they add to the sense of political crisis facing the White House. Indeed, it’s all reminiscent of the moment after the election of Scott Brown in 2010. Congressional Democrats seem to be panicking, with a handful willing to support legislation that could cripple the exchanges and guarantee failure down the road.

Combined with the botched rollout, mass cancellations on the individual market, and questions about the president’s honesty, the numbers add to the sense of political crisis facing the White House.

It’s hard to overstate the political fallout of a Democratic retreat. If the Affordable Care Act were to collapse as the result of an ill-considered “fix” that would gut the law, the health-care market would plunge into chaos, ruin the party’s political standing, and destroy Obama’s legacy. No one would touch health-care reform for another 20 years, to the huge detriment of the country and millions of uninsured Americans.

On the other hand, of course, the Affordable Care Act could still fail of its own accord. So the best choice is still a relentless effort from the administration to fix the website and a Democratic Party that’s willing to stand with the president and give the law time to work. Waiting won’t be easy, and supporters will pay a political price for Obamacare’s problems. But the potential gains to millions of Americans—uninsured and otherwise—are too great, and too important, for Democrats to retreat.