Apr. 18—President Barack Obama said Thursday 8 million people have “signed up” for coverage in the government-run health insurance marketplaces created by his signature healthcare law.

The announcement came two days after the end of an extended enrollment period the administration allowed for the marketplaces’ first open enrollment period.

The enrollment numbers are likely to change, however, because they include people who have not paid their premiums and whose coverage will be cancelled, which have included 10 to 20 percent of applicants in recent studies. For example, California announced Thursday that 15 percent of its 1.4 million enrollees have not paid their premiums.

Additionally, it remains unclear how many of the new signups switched from policies cancelled by the law or were previously uninsured, which Congressional Budget Office projections said the law would reduce this year by 14 million. As few as one-third of new enrollees were previously uninsured, according to one recent survey by the Rand Corporation.

But if close to 8 million sign ups of the uninsured are sustained, then it would mark a major reversal in the Affordable Care Act’s (ACA’s) first enrollment period, which began with widespread technical failures in the fall that that made the projected 7 million enrollments look highly unlikely.

Challenges Remain

Remaining obstacles to the marketplaces’ success also emerged from Thursday’s figures, which note that the share of young adults needed to maintain insurance risk pool solvency rose to only 28 percent—far short of the 40 percent the administration said was needed.

Possibly bolstering the sustainability of those risk pools is the 5 million additional people who enrolled in individual plans directly from insurers. Insurers are required to consider those enrollees as part of the same risk pools them when setting their 2015 marketplace plan rates, the administration stated.

The administration also noted that 3 million more people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) as of February than were enrolled before the marketplaces opened. Although those figures include enrollments by people in non-expanding states who qualified under pre-ACA limits, Medicaid and CHIP enrollment will continue throughout the year.

Obama also stepped up his political attacks on Republican legislators and governors in the 24 states that have not approved expansions of their Medicaid programs to the degree authorized by the ACA. Obama attributed their opposition to “no reason other than political spite.” The administration said 5.7 million people would be uninsured in 2016 because of the lack of expansion in those states.

Rich Daly is a senior writer/editor in HFMA’s Washington, D.C., office. Follow Rich on Twitter @rdalyhealthcare.

Publication Date: Friday, April 18, 2014