Early Enrollment – Why is it Supposed to be Slow?

Earlier this week, attorney and health care blogger David Harlow made a post titled “Health Exchange Enrollment: Speed of Light or . . . Molasses.” Harlow suggested that people need to “cool their jets” about the low numbers of ACA enrollees because “early enrollment is supposed to be slow” - apparently because that’s the way it was in Massachusetts back in 2006-2007.

So early enrollment in the ACA is supposed to be slow in 2013 because the experience in Massachusetts was ‘slow’ in 2006? Seriously? These two roll-outs hardly seem comparable:

1. The ACA has been touted all over the media for 3-4 years now.  One cannot watch TV, read anything anywhere, listen to the radio, browse the web and/or drive anywhere without being inundated with information about the benefits of enrolling in Obamacare. Moreover, the ACA was front and center through last years presidential election and a high-visibility Supreme court case.

2. Hundreds of millions of dollars in paid marketing/advertising has been spent on the ACA. An equal or larger amount of exposure has been provided via supportive main stream media.

3. Internet access and technologies supporting awareness and enrollment are way more ubiquitous now – nearly a decade later - than when MA was being implemented in 2006.

4. ACA subsidies benefit those up to 400% FPL – Massachusetts up to 300%.

So far, only the easy to deploy and no-cost/low-cost parts of Obamacare have been implemented: primarily kids on their parent’s plan, elimination of pre-ex on children and removal of lifetime limits. As Harlow states, current ACA enrollee counts are likely dominated by the long-uninsured and under-insured. Yes, it’s still early, human nature is to procrastinate and a turnaround might occur. Maybe. But given the above, the overall low number of enrollees these first 6 weeks, the remaining as yet widely un-publicized issues and the challenge getting the “young invincibles” to enroll, the belief that the Obamacare death spiral may have officially begun is probably not be the fantasy Harlow makes it out to be.

We’ll all know in the next couple months.