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Dan Diamond, Managing Editor
Last week, the question on everyone's mind: Which health insurance exchanges are working? (Answer: Not many of them.)
This week? With more of those exchanges coming on line, the focus has been on how many people have enrolled.
And officials aren't making it easy to find out.
Just 5,000 enrollees across 36 states?
Thirty-six states are relying on the trouble-plagued healthcare.gov system to adminster their insurance exchanges, but the site has been so glitchy that journalists spent days last week chasing false leads in an effort to find someone who'd actually signed up.
Don't judge the exchanges' fate too soon: Join us for a conversation on November 15 as our experts perform a pulse check on Obamacare.
No one denies that the number of healthcare.gov customers is on the strikingly low side; the insurance industry is semi-privately grumbling that the enrollment figures are disappointing, and analyst Bob Laszewski estimated on Friday that "no more than 5,000 individuals and families" had gotten coverage through the site as of Monday.
And who's to say otherwise? HHS insists that it won't release data on the number of enrollees through the federal exchanges until November.
15 other exchanges report at least 42,000 total enrollees*
Meanwhile, the 15 state-based exchanges (counting Washington, D.C.) have been more transparent, but their reporting is inconsistent—different states are using different metrics, and tracking different times. The Washington Post's Sarah Kliff does a good job of breaking the funky math down here.
You can see that reflected in our chart below. Minnesota has reported the number of accounts created on its exchange website, but not the number of applications or enrollees, whereas a state like Connecticut has only reported completed applications. And a handful of the states, like Hawaii and Oregon, have had such serious IT problems with their exchanges that they haven't been able to enroll anyone at all.
All told, though, we counted somewhere north of 42,000 people* who had successfully enrolled across the 15 state-based exchanges, based on the hodgepodge of data available through Tuesday morning. (Editor's note: The chart below is now outdated, as additional information has been released since this initial post. As of October 16, our most current estimate was more than 48,450 people had either picked a plan through the exchanges or completed enrollment.)
(An FYI that this list owes a debt of gratitude to Twitterer Aaron Strauss, who was the first to do this exercise.)
As noted every time we talk about these early figures: It's too soon to say exactly what this means for the health care industry, especially because we don't know who these enrollees even are and what plans they're buying, which has serious implications. And there are vagaries around how states are counting "enrollees," especially given that the first premium payments for plans that start on Jan. 1 may not be due until Dec. 15.
But there is broad consensus: For the ACA to be a success, the number of IT glitches needs to go way down, and the number of exchange enrollees needs to keep going up.
How do health insurance exchanges work?
Government officials often compare the exchanges to online travel sites like Expedia or Orbitz. But given that many exchange websites aren't fully functional yet, I find it helpful to picture a big box store.
For more: Read our primer, or our white paper, for answers to eight key questions and implications for providers.