Not only does today mark a new beginning with the calendar crossing over to 2014, but it also signifies the official halfway point of Obamacare's open enrollment period.
Whether you realize it or not, Obamacare's health exchange marketplaces have been open for business for three full months now, and it's been nothing short of a rollercoaster ride for both the state and federally run exchanges, as well as consumers. Technical glitches on federally run Healthcare.gov as well as a myriad of other delays led to weaker than expected enrollments through the first two months, but big changes -- both good and bad -- were afoot in December.
Here are the 10 Obamacare facts that really matter after the first three months.
1. The Obamacare website is working properly.
In spite of all the heat that Healthcare.gov has taken over the first two months, the tech surge led by Oracle, Red Hat, and Google worked as planned and now has the health exchange operating normally in all 36 states that it covers. Perhaps an even bigger beneficiary than Obamacare is CGI Group (NYSE:GIB), the Canadian company that designed and built Healthcare.gov can. While it could take months for these delays to blow over, the lack of a seriously protracted website errors may mean only a minimal loss in future business orders for CGI Group.
2. More than 1.1 million people signed up using Healthcare.gov through Dec. 24.
Although we're still waiting on the official state totals, through Dec. 24 (the coverage cutoff date to enroll for health insurance still be covered by Jan. 1) Healthcare.gov had enrolled more than 1.1 million people, a better than 975,000-person jump from the previous two-month total of 137,204 and more than a 700% total increase. This spike in enrollments shouldn't come as a surprise since most Americans are procrastinators when it comes to paying their bills, so waiting until the last minute to enroll and pay the insurance premium isn't shocking in the least.
3. The December coverage cutoff deadline is meaningless.
There are really only two Obamacare deadlines that matter, and the Dec. 24 coverage cutoff for Jan. 1 isn't one of them. While this deadline may have been important for those people who are Medicaid-eligible or sick and in need of care, the primary deadline of importance is March 31. According to the Patient Protection and Affordable Care Act, citizens can go three months out of the year without insurance and still be exempt from the individual mandate penalty. In other words, we're probably going to have a very back-loaded number of enrollees come late March. The other key date is Nov. 15, which is when open enrollment for 2015 will kick off.
4. Nearly 6 million Americans are set to lose their insurance because of Obamacare.
Despite the surge in enrollments that could top 2 million when state-run exchanges are included, estimates from Forbes show that roughly 6 million people will lose their health insurance because of the more encompassing health benefits definitions of the Patient Protection and Affordable Care Act. The Centers for Medicare and Medicaid Services is going to allow these 6 million people, if applicable, to claim a hardship exemption, which will exclude them from the scope of the individual mandate, and to let them purchase catastrophic insurance, which normally wouldn't meet the benefits requirements for the remainder of 2014.
5. Obamacare isn't affordable for all.
Perhaps one of the most striking things we learned was the admission from the CMS based on the cancellations that not all Obamacare plans are affordable. To qualify for the hardship exemption, according to the CMS (link opens a PDF), you would, "need to complete a hardship exemption form, and indicate that your current health insurance policy is being cancelled and you consider other available policies unaffordable." Although the emphasis on the end of the previous sentence is all mine, it points to a common realization that no plan, no matter how universal it appears, benefits everyone.
6. More than 1.9 million people have completed the application process.
Yet for all of Obamacare's flaws, it also offers plenty of promise to meet its enrollment targets despite being way behind the 8-ball. As of the end of November, more than 1.9 million people had completed their identification and subsidy check applications -- which is an arduous and time consuming process that I can attest to firsthand -- but had yet to select a health plan. It would seem plausible that a majority of applicants will eventually sign up (and may have done so before Dec. 24), but we won't have the more precise figure of how many of these "deferred enrollees" are still sitting out there until perhaps the second week of January, when the Department of Health and Human Services releases its next set of enrollment figures.
7. Former Microsoft Office executive Kurt DelBene is now in charge of Healthcare.gov.
We have a new face manning the helm at Healthcare.gov in Kurt DelBene, the former Microsoft (NASDAQ:MSFT) executive who oversaw the development of Office. DelBene will replace outgoing Healthcare.gov head Jeffery Zients, who is taking the position of director of the National Economic Council this year. While DelBene does bring with him decades of software experience, he also hails from a company (Microsoft) that's been stuck in neutral on the innovation front for the past decade. The good news is that Healthcare.gov needs very little in the way of software integration so much as it needs cheerleading and improved awareness, which DelBene may have a shot at bringing to the table.
8. Obamacare sentiment is worsening.
Ironically, as Obamacare's website was malfunctioning, favorability toward Obamacare had improved slightly. With Healthcare.gov now working properly and enrollments surging, favorability toward the law has hit a two-and-a-half-year low, according to a CNN/ORC International poll, while opposition to the law is at an all-time high. This very well could be as a result of the fluid and ever-changing deadlines associated with coverage cutoff dates, but the worsening sentiment appears to coincide with the growing number of individual policy cancellations more than anything. One thing for certain, though, is that if sentiment continues to plummet, then it's increasingly unlikely Obamacare will reach the HHS's 7 million-person enrollment target by the end of March.
9. We still have no clue how many young adults have signed up.
Socrates once said, "As for me, all I know is that I know nothing," and that perfectly sums up how much we know about how many young healthy adults have signed up for Obamacare. Thus far we've received fairly detailed information about each state, as well as Medicaid versus paying individual enrollees, but we have absolutely no way to gauge how successful the campaign to sign up younger adults has been. This is crucial, as insurers need young adults to help counteract the higher costs of treating elderly and sick patients, which, if previously uninsured, are almost assuredly going to sign up for Obamacare. Without these young adults balancing out these costs, premiums in 2015 could head much higher.
10. The individual mandate not only isn't going anywhere, but it's now in force.
Finally, for those of you thinking that Obamacare would be repealed or that the individual mandate would be delayed ... it's not. As of today, the individual mandate goes into effect, meaning currently uninsured people have three months to enroll in a health plan or they will be penalized the greater of $95 or 1% of their annual or household income on their 2014 tax return. Today also marks the start of coverage for the estimated 2 million people to have enrolled on or before Dec. 24.
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Fool contributor Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.
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