October Was Not a Banner Month for Obamacare Enrollment

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I got a repetitive stress injury trying to reload this broken site all day long and now my hand doesn't work. Photo: Yoon S. Byun/The Boston Globe via Getty Images

The Department of Health and Human Resources released the October enrollment figures for Obamacare, and ... they're through the roof! Millions of uninsured Americans managed to bypass a broken website, somehow hack into the federal database, and enroll themselves in the program several months before it starts working!

No, obviously that didn't happen. What happened instead was that a bunch of people tried the website, but not many actually got through. Jonathan Cohn explains:

According to HHS calculations, 846,852 people have used the site to complete applications. That means they have created accounts and submitted information to see whether they are eligible for federal programs or tax credits. Those applications include people applying for households with multiple members. In total, it represents 1,509,883 people. The federal government has processed applications for the vast majority of them — 98 percent, or 1,477,853 people. Of those, about a third have actually selected a health plan or been deemed eligible for a program like Medicaid. That’s 502,466.

How does that half million break down? About four out of five (396,261) are in Medicaid. The rest (106,185) of them have picked private insurance plans.

Why have so many more people enrolled in Medicaid than the exchanges? Because it's a much easier decision. If you're below a certain income threshold, and you don't live in one of the states run by politicians with a sociopathic indifference to the basic human needs of their most vulnerable citizens, then you have one option for subsidized health care: Medicaid. Nobody loves being on Medicaid, but it's better than nothing, so you enroll.

If your income is above that threshold, you can enroll in the exchanges and possibly receive tax credits to offset some or all of that cost. In an exchange, you choose between a bunch of different plans offered by a bunch of different insurance companies. Making that kind of choice can be a huge pain, so people tend to put it off, especially when they still have a couple of months to do it, and all the more so when the website is a national punch line.

When Massachusetts implemented its socialist Romney-designed health-care plan, a huge proportion of customers waited until the last minute to enroll. Presumably the same thing will happen when healthcare.gov gets fixed, unless — and this scenario is looking more likely all the time — the Earth is destroyed by a meteor first.