Exchange Enrollment Trails Projections

The good news: California enrolled about one out of every three Americans last month into commercial health plans as part of the rollout of the Affordable Care Act.

The bad news: The initially low enrollment numbers for the Covered California health insurance exchange means it may face a challenge meeting its first-year goals by the time the open enrollment period ends on April 30.

Overall, a total of 30,830 were enrolled into commercial health plans during the month of October, the first month of enrollment through the exchanges. Of those, 4,852 were eligible for tax subsidies. Another 72,000 applicants were considered eligible for Medi-Cal.

However, commercial enrollment picked up significant strength during November, with 29,000 enrolled through Nov. 12, bringing the total up to 59,000.

Altogether, Covered California reported that 203,904 applications were started that would cover 370,000 people if completed. A total of 97,494 applications were completed, representing 177,331 individuals. 

“The numbers are better than encouraging. They show momentum and very high consumer interest,” Covered California Executive Director Peter Lee said in a statement. “As anticipated, consumers spent October comparing plans and educating themselves about their healthcare options, including financial assistance options.”

But given the current daily enrollment average of 1,372, about 289,000 would be enrolled in commercial plans through Covered California by April 30, when the open enrollment concludes.

Earlier this year, Covered California projected between 500,000 and 700,000 would be enrolled into commercial health plans by the end of the open enrollment period. Even at the accelerated November numbers, Covered California would only meet the low end of its enrollment projections.

Officials with Covered California and the Department of Health Care Services, which oversees the Medi-Cal program, were not immediately available for comment on Wednesday.

“While these initial numbers fall short of enrollment goals, they are not surprising,” said Carmella Gutierrez, executive director of the advocacy group Californians for Patient Care. “Many Californians are looking under the hood and kicking the tires before they make such an important decision for their families.”

Whether the bug-filled rollout of the federal health insurance exchange affected Covered California's enrollment numbers remains to be seen. Federal officials reported that only 106,185 enrolled through Nov. 2, with fewer than 27,000 doing so through healthcare.gov, the federal exchange. The Obama Administration had originally projected as many as 500,000 people would enroll in the first month.

"No one will be satisfied with the numbers because they will be below what we sought prior to the launch," White House spokesman Jay Carney said.

In contrast to the frustrations expressed by consumers in using healthcare.gov, 88% of Covered California applicants said they were able to find the information they needed to enroll. And 69% said the enrollment process was easy.

Gutierrez said bolstering outreach efforts would be critical if the enrollment numbers are to grow in the coming months.

“Extensive outreach and educational efforts throughout California’s diverse communities must continue during the open enrollment period so people understand basic elements of the new health law. This includes the opportunity to receive financial assistance if eligible,” she said.

Carla Saporta, health policy director for the Greenlining Institute, an advocacy group for increasing the numbers of insured, said a massive statewide enrollment campaign that will last a month will be launched on Friday.

The campaign will include various in-person enrollment events in Sacramento and other cities. 

“I think as we move forward, we need to be targeting efforts more specifically,” Saporta said. She added that her organization also wanted to see how enrollment was going by specific demographic groups such as African-Americans and Latinos, who have been underinsured compared to the state's Anglo population.

Covered California officials indicated they would release more data – including enrollment numbers by demographic groups – later this month.

“We can't just look at the (current) numbers,” Saporta said.