Obamacare has beat its revised goal of enrolling six million people on the federal exchange, with new signups coming it at 7.1 million by the end of March. But all may not be as it seems. One point we’ve emphasized about this enrollment number is that it doesn’t tell us how many of those signing up were previously uninsured. The law was supposed to expand access to the previously uninsured, not kick people off their current plans and on to the exchanges. And there’s another way this announcement could be misleading. We don’t know how many of those seven million will pay their premiums. If Americans sign up now only to miss payments later, the initial enrollment figures will wind up telling us little about how successful Obamacare has been.How many will pay their premiums? Megan McArdle makes a fascinating point. Because forty percent of total signups came later, McArdle argues that many of these signups were from one of three groups:
1. People who are incredibly disorganized.2. People who are so financially pinched that it was important to wait until the last minute so that they could pay eight months’ worth of premiums instead of 12.3. People who are young and healthy enough to make acquiring insurance less than urgent.
If this is true, then the last-minute surge will be both good and bad news for Obamacare. It’s good news because young procrastinators could shift the demographics of the exchange risk pools. The younger the pool, the better the exchanges will work. It’s bad news, on the other hand, because the “financially pinched” would be less likely to pay their premiums. Only time will show how all these factors shake out, but it’s clear that there’s much more ambiguity built into the enrollment number than Obamacare’s cheerleaders are willing to admit.