Obama Administration Says 7.3 Million Paid Enrollments in Obamacare Exchanges as of August

The
Obama administration said this morning that about 7.3 million
people were paid and enrolled in insurance through Obamacare’s
exchanges as of August 15.

The figure represents a decline of about 700,000 from the 8
million the administration said were signed up for coverage at the
end of April. The decline stems from people signing up but not
paying, or from choosing drop coverage.

This is the first time the administration has provided a paid
enrollment figure. Previous estimates for Obamacare coverage have
relied on the number of people signed up, not the number of people
who finalized their enrollment by paying.  

The 7.3 million figure is not quite current; instead, it
represents a “snapshot” taken on a single day in August, Marilyn
Tavenner, the head of the Centers for Medicare and Medicaid
Services, told members of Congress this morning. 

Even still, that figure is likely to decline at least somewhat
going forward. For one thing, it doesn’t account for the 115,000
people who could lose their coverage at the end of September as a
result of
failing to verify their citizenship. Nor does it account for
people who may choose to drop coverage after losing a subsidy
because they failed to verify their income.

The figure is also potentially complicated by the
90-day grace period for premium payment the law requires
insurers to abide by.

Tavenner’s statement this morning
said that, on August 15, “we have 7.3 million Americans
enrolled in Health Insurance Marketplace coverage and these are
individuals who paid their premiums.”

Presumably, then, these are all people who have made at least
one initial premium payment. But we don’t know for sure if they
kept paying; it’s possible that some of them paid once and then
failed to pay. Insurance industry consultant Bob Laszewski has said
that insurers
expect a monthly attrition rate of 2-5 percent even after
initial premiums are paid. 

That would mean that most people who signed up in the final
enrollment surge at the end of March and had coverage begin in May
would be in the window, as would
the 910,000 people who signed up in the special enrollment
period in April, many of whom didn’t have coverage go into effect
until
the beginning of June. 

An August 15 snapshot could be capturing people who paid the
first premium for May or June, and then missed later payments.
Without recurring report on sign-up and payment trends, however,
it’s somewhat difficult to tell. 

As Reason’s J.D. Tuccille noted earlier this
week, the grace period built into the law makes it possible for
someone to sign up for coverage, not pay premiums, and use the
coverage at a doctor’s office—eventually leaving the doctor on the
hook for the bill.

Still, the new figure suggests that the large declines in
enrollment
reported by Aetna, a health insurer which indicated that it
could see as much as a 30 percent drop in its Obamacare plans by
the end of the year, are probably not representative of any larger
trend. And they suggest that overall paid premiums are
at least somewhere in the range of the 7 million (perhaps a little
lower or a little higher) initially projected by the Congressional
Budget Office.