Blog Post

Obamacare exchanges by the numbers, one month later

November 1, 2013

    Dan Diamond, Managing Editor

    October 1 was a huge day for the health care industry—and specifically, it was a "huge day" for traffic to the new federal insurance exchange websites, according to White House advisor David Simas.

    "4.7 million visitors to," Simas tweeted. "190k calls. Americans are enrolling."

    Simas was technically right. After weeks of uncertain reports, we know now that Americans did enroll on Oct. 1.

    There were six of them.

    Where we stand after one month

    That early enrollment number comes from documents released on Thursday by House Oversight and Government Reform Committee Chair Darrell Issa (R-Calif.), Sharyl Attkisson reports for CBS News.

    The Obama administration turned over the documents in response to Issa's request for information from "war room" meetings involving CMS, federal contractors and Obama administration officials.

    (Enrollments through remained low but did rise quickly; they went from six people on Oct. 1 to 248 by the morning of Oct. 3.)

    Yet one month in, we still don't know the status of total sign-ups through the federal exchange, which covers 36 states. On Wednesday, HHS Secretary Kathleen Sebelius said that her agency couldn't trust the data that had come in so far, given the status of the exchange's IT systems and faulty information being sent to participating insurers—but she warned that total enrollment would be a "very small" figure, given the myriad technical problems with

    HHS has said that it will release enrollment data later in November.

    More than 150,000 people use state exchanges to find coverage

    Meanwhile, the Daily Briefing has been tracking enrollment reported by the states through the first month, which gives us some picture of how many people have used the fifteen state-based exchanges to sign up for new health coverage.

    And our latest count, based on data that state officials have made available, found that more than 155,000 people had either signed up for private plans or enrolled in Medicaid coverage by the end of the month.

    (Click here to see a pop-up chart of that data)

    A few important clarifications and reminders, however.

    First, states aren't all reporting the same data points; officials at Covered California, that state's exchange, have mostly focused on the number of applications for coverage that were started—about 180,000 as of Oct. 26.

    And that's very different than the figures reported by many other states: the total number of completed applications, and the number of residents covered through them.

    Kentucky, for example, reported 31,545 people had been enrolled in new coverage as of earlier this week.

    About half the states have offered an even more detailed breakdown of which sign-ups were in Medicaid and which were for private coverage. (Click here for a pop-up state-by-state chart.)

    According to data released by the states, and our own tabulations, more than 75% of early enrollments reported in October were sign-ups through Medicaid.

    It's not a surprise that Medicaid would be outpacing private plans in the early going, especially in states like Kentucky, Minnesota, and Washington. State officials and advocates had done tremendous work on outreach, and Medicaid is an auto-enroll whereas customers have to decide what to buy (and if they're ready to pay) when picking a private plan.

    And there's every indication that the number of sign-ups for private coverage will rise as the deadline gets closer and states iron out the technical problems that are preventing them from transmitting the 834 data files to insurance companies.

    Still, the early balance is eye-catching, experts told me when the Daily Briefing first surfaced these figures almost two weeks ago.

    What you need to know

    We'll be pulling up to do a pulse check on Obamacare on Nov. 15, where we'll review these early enrollment trends and what they mean for providers, but also talk through the ACA's delivery and payment reforms—which have been little discussed this month, but are helping to reshape the industry.

    Join us for the discussion and feel free to send questions in advance.

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