ObamaCare Week 23: 4 Million Enrollees, and a Longer Work Week?

With just four weeks of open enrollment left, the Affordable Care Act has four million enrollees.

President Obama announced Tuesday at an Organizing for Action event that four million Americans have now selected plans on both state and federal exchanges, a slight increase from the 3.3 million enrollees announced Feb. DAY.

The enrollee announcement bucked the trend the Department of Health and Human Services has followed since open enrollment kicked off on Oct. 1 of sending out releases with new figures.

Under the ACA, every individual in the country has to have insurance by the end of open enrollment period on April 1, or they will face a fine of $95 or 1% of their annual income for failing to comply. The insurance industry typically considers individuals enrolled once they have paid their first month’s premium, but HHS counts doesn’t make this discernment.

Because of this, Yevgeniy Feyman, Manhattan Institute scholar, says the accuracy of the new numbers are unclear.

“Even if it is at four million, we still don’t know who is enrolling and the health status of these people,” he says. “The administration has played this off, saying the pace for young and healthy enrollees has upticked, but their share has barely budged.”

The latest report from HHS showed young enrollees, those ages 18-to-24, made up about 25% of the new signups. Young and healthy people are needed to offset the costs of insuring older and less healthy enrollees.

Susan Dentzer, senior advisor to the Robert Wood Johnson Foundation, says enrollment directors have long said we would see a surge in enrollment as the deadline approached.

“If we go on that supposition, the CBO analysis [of six million enrollees in year one] may be right,” Dentzer says. “It’s on the high side, but we could get at least one million more, or maybe two million enrollees.”

Medicaid Math

More math surrounding the law came into question this week after President Obama said that seven million Americans were gaining access to Medicaid “for the first time” due to the program’s expansion under the ACA. The Washington Post called foul, and gave the statement, made at the Democratic Governor’s Association dinner, “four Pinocchio’s”. Feyman says the stats are off, and are likely closer to one to two million as others have estimated.

“We won’t know the exact number of people until we know their income level,” Feyman says. “We won’t know how many of these new enrollees are actually due to the expansion until then.”

A Longer Work Week?

The GOP’s plan to lengthen the definition of a full workweek got cut down by the Congressional Budget Office this week. H.R. 2575 would change the ACA’s definition of a full-time worker and increase the requirement to 40 hours a week from 30 hours.

The employer mandate portion of the law requires every business with at least 50 or more full-time workers offer those workers coverage or face a fine of $2,000 per worker, per year.

The CBO’s report said more than 1 million people would lose their employer-sponsored health-care if the bill passed.

The employer mandate was slated to kick in in 2014 but it was pushed until 2015. Now, businesses with between 50 and 99 workers have until 2016 to comply, but those with 100 full-timers and up have to begin offering coverage next year.

The mandate was going to have winners and losers, regardless, Dentzer says. This shows that no matter how the law is enforced, workers will get pinched.

“There was never any free lunch in passing any form of an employer mandate in the first place,” Dentzer says. “And there’s no free lunch in changing it. There are consequences to doing that, and more people will be in exchanges and will receive subsidies as a result.”