If the success of Obamacare's health exchanges were measured in the number of fingers pointed over the past three weeks since it went live, then its success would be off the charts. Unfortunately, finger pointing doesn't count, and aside from a scant group of 10 state-run exchanges that reported their early stage enrollment figures last week, it's been like pulling teeth trying to get an update regarding enrollment figures at the federally run Healthcare.gov from the Department of Health and Human Services -- until now.
Source: White House on Flickr.
According to an Associated Press report over the weekend, administration officials announced that a combined 476,000 people had submitted applications for health insurance on state and federal exchanges. This figure doesn't give us any information as to whether people completed the application and obtained health insurance, but it's a good starting point.
Breaking it down further, the administration's data notes that a bit more than half of the 476,000 applications have come from the federally run Healthcare.gov, and that, in the interim, it's encouraging people to use call centers to sign up for health insurance. In fact, call center head count has been beefed up by 50% to meet increased questions and demand while technicians continue to work out the numerous architectural flaws in the government-run website.
Finally, we also found out that the number of people who had visited Healthcare.gov through Friday night had risen to 19 million.
Are these numbers good enough?
The big question on everyone's mind, especially with the innumerable glitches many Americans have encountered, is whether Obamacare is succeeding. The answer to that question is both yes and no.
Clearly Obamacare is a success in a handful of states such as New York and Washington, which have seen few state-run health exchange issues. My home state of Washington, for instance, had its health exchange go down on the first day due to an overwhelming amount of traffic but hasn't logged any major problems since.
Obamacare is also succeeding in bringing previously uninsured Americans with preexisting conditions who had been denied by insurers otherwise into the fold. Perhaps not the best news for insurance companies in this respect, it is great news for hospital providers like HCA Holdings (HCA 1.64%), which would expect to see a reduction in doubtful accounts with more of its sick patients being covered by insurance. Last year, HCA wrote off about 10.3% of its revenue as uncollectable because it treated patients who were uninsured or simply couldn't pay their bill. With the individual mandate soon to become an enforceable law on Jan. 1, 2014, the expectation is that lower doubtful account provisions (and thus better margins) could allow HCA to purchase state-of-the-art medical equipment or perhaps repurchase its own shares or initiate a dividend.
These numbers don't add up
Then again, the pace at which consumers are enrolling looks painstakingly slow and bogged down primarily by Healthcare.gov's ongoing glitches.
Let's recall that the administration's figure of 476,000 is for applications, not enrollments! For all we know only half of those people may have completed the application process or even less! Furthermore, the administration has absolutely no plans to update actual enrollment figures before mid-November -- more than likely because it gives HHS time to fix some of the more serious problems with Healthcare.gov.
Based on last week's state-run health exchange enrollment figures obtained through the 10 reporting states, we were able to extrapolate out an enrollment rate through the enrollment cutoff date of March 31, 2014, of roughly 2.8 million people. This figure was more or less in line with previous enrollment forecasts. However, if only about 250,000 people have applied for health insurance through three weeks on federal exchanges, Obamacare's enrollment target of 7 million people is likely to wind up around 2 million people short come the coverage cutoff date!
The good, the bad, and the ugly for your investments
The way it's shaping up right now, insurers, hospitals, and IT companies tied to the federal exchange are probably going to struggle to meet the lofty near-term expectations of shareholders, while those operating predominantly in state-run locales will be in good shape.
If you want a ray of sunshine in this mess, look no further than either WellPoint (WLP 2.75%) or Molina Healthcare (MOH 3.27%). Both companies have a stronghold in California with WellPoint's Blue Cross Blue Shield and Molina's low-cost and Medicaid-sponsored plans offering ample choices in the early going for consumers. Although early enrollment in California was disappointing, the expectation all along has been that it would pick up as we get closer to coverage enrollment cutoff date. With few signs of exchange problems in California I'd look for these two companies to impress investors moving forward.
On the other end of the spectrum we've got hospital operator Tenet Healthcare (THC 1.78%) which on the surface would like a pedestrian investment that shouldn't be affected too much by the ongoing federal glitches. However, Tenet's hospitals, with the big exception of California, are located primarily in states operating on the federal health exchange. In other words, Tenet shareholders probably shouldn't expect its doubtful accounts provision to drop dramatically anytime soon with enrollment figures pacing well below expectations at the moment.
It could be even uglier for CGI Group (GIB 2.42%) as I've touched on previously. It's not that this software developer of Healthcare.gov isn't getting its fair share of pay for its time and effort to construct the federally run website. It's that the negative publicity surrounding the event and its inability to quickly fix what are growing problems in the system could damage its reputation for years to come, possibly costing the company future orders.
A better gauge
The administration's application figures are certainly great to have because it finally gives us some indication of how strongly enrollment and public interest are proceeding. However, I would suggest not getting too caught up in data that's hardly even three-weeks old yet. The main reason is that it's difficult to get consumers to pay for a product that doesn't even go into effect until Jan. 1, 2014. Therefore, a good chunk of visitors to the state and federal sites are likely just gawkers right now. This means a surge in enrollment figures is likely to come on the back half of the coverage period. So while many would be tempted to call Obamacare an utter failure based on these early results, we're still a long ways away from the meat-and-potatoes part of the enrollment period. Until we get well into December and January, it's going to be difficult to decisively call it a victory or failure.
