Published November 15, 2013
The Affordable Care Act experienced two major markers in its seventh week of open enrollment season: enrollee numbers for the first month and a fix from the president for the millions of Americans receiving policy cancellation letters.
Enrollment stats were disappointing with 106,185 Americans selecting plans on state and federal exchanges, the Department of Health and Human Services reported Wednesday.
On Thursday, President Barack Obama announced an administrative fix that allows consumers who have received word that their policies had been cancelled because they don’t meet ACA standards could get them back through 2014 if state regulators and insurance companies allow it.
The rollout of the healthcare.gov has been rocky since it opened on Oct.1, but Larry Kocot, Brookings Institution visiting fellow, says this week’s events created an even bigger uphill battle for the legislation.
“I am both discouraged and disappointed by the events of this week,” he says. “I am still hopeful they can pull this off, but their job is much more difficult after this week.”
After a month of speculation, HHS released enrollment numbers that fell short of the pace needed to hit the administration’s goal of enrolling seven million people in year one of the ACA. In addition to the barely more than 100,000 who had selected plans, an additional 975,407 had made their way through the majority of the process by applying and receiving an eligibility determination.
Yevgeniy Feyman, a scholar at the Manhattan Institute, says he is troubled by the fact that the administration is including those who may or may not have paid for their monthly premiums in the enrollment data.
“The numbers are disappointing,” Feyman says. “It's about 1.5% of what the Congressional Budget Office had projected for 2014. And on top of that, we are counting people who have not actually enrolled and paid for that first month’s premium.”
Kocot wasn’t surprised by the low numbers. “This is not anywhere near what the administration needs to be successful in the long run. They have to demonstrate confidence and show they are in charge of the system for people to flock to the exchanges . And there is a lot of work involved for that to happen.”
There was a bright spot in the HHS enrollment numbers report: State exchanges are continuing to fare better than the troubled Healthcare.gov site. The report showed 79,391 Americans had enrolled via state exchanges, which includes 14 states and the District of Columbia, compared to 26,794 enrolling on the federal exchange.
“The state exchanges I am hopeful for,” Feyman says. “They are working moderately well. Unfortunately, many Republican states refused to set up exchanges and they will be stuck with the dysfunctional federal exchange.”
Last week, the White House set a Nov.30 deadline for fixing the federal exchange’s website, but Feyman is skeptical that target will be met. “It’s way too optimistic, especially when the administration is going back to the same people who built the site in the first place,” he says.
Kocot says the Healthcare.gov situation is ‘dire’ and that each passing day that it is not functioning properly chips away at public confidence in the Obama Administration.
“There is now a strong possibility that the greatest domestic success of the first Obama Administration could become the greatest failure of the second Obama Administration,” he says. “When a president has to apologize multiple times for the issues related to the rollout… a sorry administration will not sell this program.”
The president’s speech on Thursday shows a continuation in the breakdown of political management in regards to handling the rollout, Kocot says. The president said he “didn’t know” the site would not be operating at full capacity ahead of the rollout.
"I think it's legitimate for them to expect me to have to win back some credibility on this health care law in particular and on a whole range of these issues in general," Obama told reporters Thursday. "And, you know, that -- that's on me. I mean, we fumbled the rollout on this health care law."
U.S. Chief Technology Officer Todd Park testified before Congress on Wednesday in the latest set of hearings on the botched debut.
“We’ve heard from career staff and political people, and the career staff don’t deserve the blame for these political failures,” he says. “Those are between the administration and Congress. The career staff are incredibly talented public servants, but they can’t perform at their peak unless they are given clear direction, and priorities are known.”
The cancellation fix may please consumers if they are able to get their old coverage back next year, but Feyman says it shifts the blame from the administration and places it on states and insurance companies.
“This puts the onus on insurers now,” he says. “The administration is being clever about it, because they are requiring insurers to let people know about all of the other options available. More information is good, but why would you tell people about your competitors? Now insurers basically have to market other companies’ plans.”