- With three enrollment seasons under its belt, President Obama's healthcare law has brought just half the number of marketplace plan enrollments that were originally projected by this time, and there's more to why that is than what the government says, according to U.S. News & World Report.
- The administration has repeatedly pointed toward one reason: Employers have continued to provide health coverage themselves rather than sending their employees to the exchanges, as analysts had predicted many would do.
- While that is one factor, the math doesn't support it as the sole factor for why, after analysts projected three years ago that 24 million people would enroll in ACA plans by 2016, the current tally is just 11.1 million.
Whether or not the White House sees other factors at play, it stands to benefit by blaming ACA enrollment shortfalls on the continuation of employer health plans, because fear about losing those plans was one of the key arguments against the health law.
"This actually is an example of yet another of the worst predictions about Obamacare not coming true," White House press secretary Josh Earnest said at a Monday press briefing, implying the continued employer benefits to be good news.
However, based on data from the Congressional Budget Office, continued employer coverage accounts for about 6 million people, leaving about another 7 million unaccounted for in the overall shortfall of 13 million, according to U.S. News & World Report.
It suggests several possible explanations, aside from the difficult nature of making such projections in the first place.
One possibility is that with 16 million more people than expected having enrolled in Medicaid and the Children's Health Insurance Plan -- either through expansion or discovering that they had been eligible already -- those numbers may have partly come from some who had been expected to turn to the marketplaces. However, it's unlikely expansion has had any actual drain on ACA signups given those who qualify for Medicaid would be unable to afford marketplace plans.
According to MIT economics professor Jonathan Gruber, other possibilities are that the ACA's mandate to buy a plan or pay a penalty has been less motivating than expected, and that states where elected officials oppose the health law are causing their lower enrollments through their lack of support.
Another explanation from Charles Gaba of ACASignups.net noted analysts had projected that about 4 million people would switch from buying individual policies through brokers to buying through the exchanges, but that didn't happen, with part of the reason being that there was no incentive for people who wouldn't qualify for federal assistance. He added there are probably also some people who haven't switched because they don't realize they would in fact qualify for subsidies.