Monday, November 11, 2013

Obamacare and the Numbers

This is the week that the government will release the number of enrollments for Obamacare. There are several possibilities for what those numbers will be. They may be much higher than anticipated showing that the exchanges and the enrollment process are working well. Its possible but not likely.  We may be told that the release is being delayed for some technical reason. If so you can bet that the numbers are lower than anticipated, I'm talking much lower, like just a couple of hundred thousand or less. The enrollment figures may be massaged into a useless pile of statistics. They will be expressed as percentages of population, with portions of the population cut out of the equation to make it either difficult or  impossible to get an accurate count. The worst case for this is if they are able to create a method of getting several different totals making the whole mess open to interpretation. This of course will allow both the pro and con sides to declare a win and we won't know for sure what is happening. It is also possible that the figures will not be complete enough to make a judgment on the success or failure of the system. If it is announced that two million people have enrolled but no figure is given for how many actually completed the process and set up payment for and will be covered come 1 January 2014 it will be meaningless. The worst of the lot is if the number of people who have been enrolled in Medicaid vs the number in the private exchanges is not included. In some states the number being placed in Medicaid is running 25 to 1. The administration has said they need at least seven million people to sign up for the ACA and that 40% or more need to be young, healthy, preferably single people to make the system self sustainable. However everyone is surprised at how many are getting placed in Medicaid. The expected figure is rising to four million or more. Will the funding for those four million come out of the pockets of the 2.8 million healthy folks who sign up? Nobody is saying.  My guess is that the actual number is going to be abysmally low. The only reason for this estimate is that the left leaning press is already coming out with articles stating that the numbers don't matter and that no matter what the are the process and the goal are a good thing and a success.

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