Lowering Expectations, or Accepting Reality?

Published November 10, 2014

Advocates of the Affordable Care Act have been looking beyond 2014’s lackluster enrollment figures (7-8 million exchange enrollees, depending on the day and the source – most of whom apparently were previously insured, according to the Heritage Foundation) to 2015 and later. One number that’s been frequently cited is 13 million exchange enrollees in 2015, based on earlier projections by the Congressional Budget Office.

Keep in mind that 13 million figure is in the context of an uninsured population estimated to be in the neighborhood of 40 million people.

Today, Health & Human Services Secretary Sylvia Burwell threw cold water on even that modest hope, announcing that they are projecting between 9 and 9.9 million enrollees in 2015:

BREAKING: HHS dramatically scales back enrollment projection

The Obama administration is dramatically reducing expectations for the open-enrollment period that begins on Saturday. HHS now expects 9 million to 9.9 million individuals to obtain coverage through the state and federal exchanges for 2015.

That range was contained in a memo (PDF) released by the agency Monday. That’s far short of the 13 million enrollments projected by the Congressional Budget Office for 2015.

HHS also slightly reduced the number of individuals who received coverage through the state and federal exchanges for this year. The agency now estimates that 7.1 million individuals have obtained coverage through the government-run marketplaces, down from the previous estimate of 7.3 million beneficiaries. In addition, HHS projected 83% — or 5.9 million of those customers — would retain coverage for 2015.

It’s possible the administration is intentionally low-balling estimates for enrollment so they can later report “better than expected” signups that fall short of the original 13 million estimate but that exceed the new, lower figure. Or it could be that, at least in their internal projections, they are conceding that Obamcare is turning out to be just a major Medicaid expansion alongside a small tax credit program that isn’t used by many people (at least not compared to the overall population of uninsured).

Either way, it’s going to be tough for defenders of Obamacare to keep insisting everything is working out as planned and hoped for.