Why the Uninsured Aren't Enrolling (Yet)



Health care expert Bob Laszewski has a fascinating post this morning that is a must-read.*  Citing a study by McKinsey reported in Saturday’s Wall Street Journal, he notes that in some states as few as one in ten consumers who bought coverage on the new marketplaces were previously uninsured.  He wryly observes that, “If this keeps up there won't be a ‘death spiral.’ Heck, so far the insurers are just re-enrolling their old customers at higher rates!”  Oh my.


Why aren’t the uninsured signing up?  Well, for starters, that’s the wrong question.  The real question is “Why aren’t the uninsured signing up YET?”  And the answer is straightforward: for the past six weeks, consumers have focused on holiday consumption.  As Federal Reserve data show,** consumers have the tightest pinch in cash flow at this time of year – which will soon be released with the disbursement of $320 billion in tax refunds when the IRS begins to accept income tax returns later this month.  To the extent that HHS is going to be successful with enrollment in qualified health plans, it could only be now.


Should that give one hope?  Maybe.  But it should also make the federal government seriously question whether fourth quarter open enrollment in the future makes any sense at all.  Since HHS is poised to finalize the open enrollment for 2015 soon, one can only hope that they don’t again try to compete with Christmas. 


For friends in the media, all statements are on the record.  Please feel free to contact me at brian.haile@jtax.com or 615-761-6929 if I can be helpful in any way.






* Laszewski, Bob, “Survey Data and Market Reports Say the Uninsured Are Not Signing Up for Obamacare,” January 19, 2014 blogpost, available at http://healthpolicyandmarket.blogspot.com/2014/01/survey-data-and-market-reports-say.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+HealthCarePolicyAndMarketplaceBlog+%28Health+Care+Policy+and+Marketplace+Blog%29, accessed January 20, 2014.


** Board of Governors, Federal Reserve, Consumer Credit Outstanding (Flows) [Historical Data], available at  http://www.federalreserve.gov/releases/g19/HIST/cc_hist_r_flows.html, accessed January 20, 2014, 2013. 



Brian Haile

Senior Vice President for Health Policy

Jackson Hewitt Tax Service Inc.

Cell: (615) 761-6929

Email: brian.haile@jtax.com

Twitter: @haile_brian