A wonkish look at ACA signups, state by state

If you’re interested in following the course of the Affordable Care Act (aka, Obamacare), then you ought to be keeping track of changes at Charles Gaba’s site ACASignups.net.

The same data is a little easier to read, I think, via this Google doc.

The spreadsheet is pretty complicated, as one would expect of such a complex law, but it clearly shows a few key things:

  • As of the end of 2013, at least 2 million Americans have signed up for private insurance through exchanges.
  • At least 4 million Americans have newly enrolled in Medicaid.
  • Most of the new enrollees in Medicaid are in states that have accepted the ACA expansion, but the so-called “woodwork effect” is leading to additional signups even in states that haven’t expanded the program.
  • Another 3 million or so Americans  in their 20s are receiving insurance from their parents’ plans — an Obamacare provision that has been in place for three years.
  • So that’s over 9 million Americans who have insurance today because of the ACA.
  • That 9 million does not include any Americans who bypassed the exchanges because of technical problems and signed up directly with insurers on the exchange.
  • Predictably, states like Georgia that did not set up their own exchanges, that did not accept the Medicaid expansion, and that are making no efforts to market the ACA are seeing relatively few new residents being covered under the law.
  • For example, Georgia has only had about 7,000 exchange enrollees and about 11,000 new Medicaid signups. Compare that to the almost 2 million uninsured residents of Georgia
  • Kentucky, on the other hand, which set up its own exchange and has expanded Medicaid, has already seen (as of 12/21) about 26,000 exchange enrollees and 74,000 new Medicaid recipients. So Kentucky has already reduced its percentage of uninsured by about 15 percent.
  • We are only halfway through the enrollment period for the exchanges — and the first two months of the federal exchange were a disaster.

It’s frequently being claimed that the exchanges need a total of 7 million signups for viability, but that’s not true. That number is the CBO projection of exchange enrollees, but the exchanges might be viable with far fewer.

I suspect we’ll see some upward revisions of these year-end numbers. We’ll likely see a pretty quiet few weeks at the start of January, but I suspect we’ll see steady numbers into March, and then see another big surge in signups in the final couple of weeks of March.

The ACA is far from perfect and has disrupted insurance for some unspecified number of Americans — some have lost coverage and others will have to pay more than they used to.

But by mid-year, we’ll have millions more Americans covered by insurance than we had just a few months ago.