The Obama administration projected 500,000 Obamacare sign-ups this month. Can that still happen?

October 17, 2013

Health and Human Services predicted 500,000 people would enroll in health coverage this month, according to internal memos obtained by the Associated Press. The memo, written in September, was based on Congressional Budget Office data projecting first year sign ups.

Achieving that milestone looks, at this point, unlikely.

But if it does happens, it will have little to do with the federal government's work, and everything to do with the states that built their own insurance marketplaces.

We don't know, at this point, how many people have signed up for health insurance through HealthCare.gov. Because the site has been very difficult to use, the assumption is not many. One outside estimate pegs the number around 36,000. That's for 34 states that tend to have the highest uninsured rates. That's not so great.

But that's not the story in Washington, where more than 25,000 applications for private insurance have been completed, and another 20,000 or so for Medicaid. And its not the case in New York, which has had 40,000 such applications come in. In Kentucky, Washington, Minnesota and a handful of other states running their own marketplaces, they’ve seen thousands signing up this month.

Taken together, state-run marketplaces have recorded just about 150,000 people turning in applications for health coverage. That's around one-third of the coverage that the administration hoped to see by the end of this month.

These are not, I should caution, final numbers. Applying for health insurance, and actually paying for the plan, are two separate tasks. The latter requires sending a check to an insurance company for the first month of coverage. Whether that happens is much more difficult for the marketplace to track.

Applications from families represent multiple people, meaning that these numbers don't represent the actual amount of coverage that people have applied for.

If the White House does hit its initial goal of signing up a half-million people in the first month, then, it will likely have these state based marketplaces to thank.

Update: Health and Human Services spokeswoman Joanne Peters emails: “The Administration has not set monthly enrollment targets.  We are analyzing data about the uninsured, state plans for enrollment, and the experience of the state of Massachusetts which implemented a similar system.  We continue to focus on reaching as many uninsured Americans as possible, based on experience on the ground.  As it did in Massachusetts and Medicare Part D, enrollment takes time.

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Neil Irwin · October 17, 2013