By the end of this month, an estimated 5.4 million people will have enrolled in health plans through the Patient Protection and Affordable Care Act exchanges, according a an analysis by healthcare business advisory company Avalere Health.
That means enrollment would be lower than the most recent Congressional Budget Office estimate of 6 million by March 31, the end of the 2014 open enrollment period for the health insurance exchanges. The Avalere analysis projects the exchanges will follow the same pattern as Medicare Part D, which launched in 2006 and saw 22 percent of voluntary enrollees sign up during the final month.
Matt Eyles, executive vice president of Avalere, says by their projections, 57,000 people would have to enroll each day in March for the exchanges to hit the 6 million mark, which "seems to be a bit of a stretch goal at this point."
Earlier this week, HHS reported more than 4.2 million people had selected health plans through the PPACA marketplace as of March 1. In February, 942,833 people selected plans, down from 1.1 million in January.
Avalere believes the health status of the enrollees will be more crucial to the exchanges' success than the raw number of people who sign up. Getting enough young, healthy people to sign up for coverage to offset the higher claims costs of older, sicker enrollees has become a focal point for policymakers and the healthcare industry as essential to the PPACA's success.
Without an adequate amount of "young invincible" enrollees, the total amount of premiums health insurers collect for exchange plans will be less than the total healthcare expenses of exchange enrollees, and insurance companies could increase premiums to compensate. However, a report from the Kaiser Family Foundation found a premium "death spiral" is unlikely to occur and insurers can still expect to earn profits even if only 25 percent of exchange enrollees are young adults.
Mr. Eyles says it's possible, however, that the exchanges could see a "significant influx" of young enrollees before the end of the month, if the exchanges follow Medicare's enrollment trajectory. "The last week to 10 days of the open enrollment period is the critical period," he says.
It also depends on whether efforts to draw young Americans to the exchanges — such as President Obama's recent plug for HealthCare.gov on the popular FunnyorDie.com webseries "Between Two Ferns" —are successful.
"We'll have to see whether the 'Funny or Die' video actually leads to an increase in enrollment," Mr. Eyles says. "We know it's lead to a significant increase in Web traffic on HealthCare.gov."
HealthCare.gov's traffic on Tuesday was up nearly 40 percent compared with Monday, following President Obama's FunnyorDie.com appearance, according to a USA Today report. Whether or not that boost in traffic will lead to higher enrollment and more stability for the exchanges remains to be seen in the last few weeks of the open enrollment period.
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