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Trying To Make Sense of the Covered California Numbers

I’ve read a number of reports in recent days gushing over the progress Covered California is making leading the nation in signing up people for Obamacare.

But, I am having trouble understanding how the numbers should make anyone gush with enthusiasm.

Covered California, the state health insurance exchange, has a goal of enrolling 500,000 to 700,000 subsidy eligible Californians by March 31, 2014.

Covered California just announced that it would proceed with its original plan to cancel 1.1 million existing individual policies (their estimate)––80% of them by December 31. Covered California also just said that 510,000 of them would qualify for a subsidy.

The only place a Californian can buy a policy with a subsidy is on the Covered California state exchange.

So, it would certainly seem that the only way those 510,000 people can continue their coverage and get a subsidy is to sign-up on the California health insurance exchange––80% of them by December 23.

So, if only the canceled policyholders who are subsidy eligible replace their canceled policies Covered California will make the lower end of its entire 2014 enrollment goal. Doesn’t sound like much of a stretch goal for them.

Besides the 1.1 million who have lost their policies because of cancellation, Covered California has estimated that 5.3 million Californians are uninsured and eligible to purchase coverage on the state exchange––about half with subsidies.


Covered California is spending $250 million in federal grant money on a two-year “outreach” campaign to get people signed up. Covered California has been awarded a total of $910 million in federal grants to fund its operations and outreach. New York, the second highest state, has received $400 million.

Through mid-November, Covered California has enrolled about 80,000 people. Its director characterized his state’s enrollment saying, “We’re seeing much larger numbers than we expected.”

The Washington Post, in a story headlined “There’s a ‘November Surge’ in Obamacare Enrollments,” reported, “California led the bunch [state-run exchanges]; the state’s enrollments have grown steadily in November and now account for nearly a full third of all health law sign-ups. The state has had its strongest two weeks of enrollment this month.”

So, let’s summarize:

  • California has 5.3 million uninsured eligible to buy in the exchange with half estimated to be subsidy eligible.
  • California is cancelling another 1.1 million people of which Covered California has estimated 510,000 qualify for a subsidy they can only get if they go to Covered California. At least 80% need to act by December 23 to avoid losing their coverage.
  • The state is spending $250 million in federal money to get people signed up––dramatically more than any other state.
  • The Covered California goal is to sign-up 500,000 to 700,000 subsidy eligible people by March 31.

Why should we be so impressed with Covered California because they have signed-up 80,000 people so far? Or, even that their goal is to sign-up 500,000 to 700,000 of the state’s 6.4 million people––half subsidy eligible––who are uninsured or having their insurance canceled?

Looking at these numbers, if they don’t have well more than 500,000 people signed up by December 31, I would have to think the number of uninsured in California would have grown.

Am I missing something here?

Robert Laszewski has been a fixture in Washington health policy circles for the better part of three decades. He currently serves as the president of Health Policy and Strategy Associates of Alexandria, Virginia. You can read more of his thoughtful analysis of healthcare industry trends at The Health Policy and Marketplace Blog, where this post first appeared.

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Mark Wilson

Great reality check on the numbers people will be seeing in the media over the next couple of months. Deserves an update early next year.