Early numbers are in: At least 7.1M have signed up for Obamacare

NYT: Millions more may have enrolled outside the exchanges

President Obama on Tuesday announced that at least 7.1 million people had signed up for coverage through the Affordable Care Act's (ACA) federal and state insurance exchanges.

Obamacare is more than exchanges: A look at the law, in three charts

Earlier in the day, White House press secretary Jay Carney said that total enrollment had crossed the 7-million mark late on Monday night, when the initial six-month open enrollment period officially ended.

The final enrollment figure surpasses the Congressional Budget Office's original enrollment projection of seven million, which the agency lowered to six million earlier this year following the troubled rollout of the federal health exchange website last fall.

A look at the final day of the initial enrollment period

Obama: Expect challenges in future, but this law is 'here to stay'

Obama said, "Despite several lost weeks out of the gate with [HealthCare.gov], 7.1 million Americans" have already signed up for coverage through the ACA's exchanges." He added, "I want to make sure everybody understands—in the months, years ahead, I guarantee you there will be additional challenges to implementing this law."

According to Modern Healthcare, Obama "ticked off other accomplishments" that he attributed to the ACA. He said that:

  • Three million young adults are now covered under their parents' health plans; and
  • 100 million people now have access to preventive care, such as contraceptive coverage and mammograms.

Obama also directed a portion of his remarks towards those who have criticized the ACA or made false claims about the law and Republicans who are continuing their attempts to repeal it. He said, "Many of the tall tales have been debunked. There are still no death panels. Armageddon has not arrived. Instead this law has helped millions of Americans. The debate over repealing this law is over. The Affordable Care Act is here to stay."

Critics: Enrollment data still lacking specific details

Several top Republican officials and other ACA critics reiterated that the Obama administration's enrollment updates continue to lack key data that would provide a complete picture about actual coverage rates and the success of the exchanges.

For example, the Obama administration has not yet announced:

  • The number of enrollees who were previously uninsured;
  • The number of enrollees who had paid their first month's premiums;
  • The number of individuals who have signed up for benefits under Medicaid; and
  • The number of younger, healthier individuals who signed up for coverage.

Senate Minority Leader Mitch McConnell (R-Ky.) said, "We don't know, of course, exactly what [the new enrollees] have signed up for, we don't know how many have paid," adding, "What we do know is that all across the country our constituents are having an unpleasant interaction with Obamacare."

NYT: Many sign up for insurance outside of the exchanges

In related news, some health care experts estimate that the number of individuals who have signed up for health insurance outside of the ACA's insurance exchanges might be in the millions, the New York Times reports.

Gary Claxton, a vice president and health care analyst at the Kaiser Family Foundation, said insurers tend to group consumers in the same risk pool regardless of how they enrolled in health plans, which means "these lives count every bit as much as the ones that came in through the exchange."

Aaron Billger, a spokesperson for health insurer Highmark, said about 30% of the nearly 133,000 individuals who have enrolled in the insurers' plans as of mid-March signed up outside of the ACA's state and federal exchanges.

According to the Times, insurer WellPoint also has reported that about 20% of new enrollees in its health plans signed up outside of the exchanges (Abcarian, Los Angeles Times, 4/1; Frank, Modern Healthcare, 4/1 [subscription required]; Easley, "Healthwatch," The Hill, 4/1; Madhani, USA Today, 4/1; Jackson/Madhani, USA Today, 4/2; Thomas, New York Times, 4/1).

Your new patients have enrolled. Now what?

For hospitals to take advantage of new exchange patients, they'll need to streamline their patient access processes to handle the increased complexities of insurance verification and eligibility, point-of-service collections, and coverage enrollment.


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