The Obama administration offered “no magic number” of people that needed to sign up for health care on the marketplaces.
Obama economic adviser Gene Sperling during an interview Sunday on NBC’s “Meet the Press”
What botched rollout? That was so 2013.
Talking points from President Barack Obama’s advisers are pointing to something new about Obamacare, something that sounds good: About 2.1 million people signed up for health insurance plans through the federal and state marketplaces.
NBC’s “Meet the Press” host David Gregory posed a key follow-up question to Obama economic adviser Gene Sperling during Sunday’s show: Is the progress good enough for the administration to meet its original goal?
Gregory noted that 2.1 million have signed up, then said: “The goal is 7 million by March. How do you think you realistically get there?”
“Well, first of all, there’s no magic number,” Sperling said. “The key is to enroll as many people, have an exchange that’s working, have a stable exchange …”
“The secretary of health and human services said that was success, 7 million by March,” Gregory said.
“I think success is having an ongoing, strong market,” Sperling said.
PolitiFact wanted to know: Is Sperling trying to rewrite the past by saying Obama had “no magic number” for the number of people who need to sign up for coverage by the end of open enrollment in March?
The 7 million mark
On at least two occasions Health and Human Services Secretary Kathleen Sebelius referred to 7 million as the mark.
The number, though, didn’t come from her. It originated with the nonpartisan Congressional Budget Office, which analyzes the impact of legislation.
In February, the CBO estimated 7 million people would sign up for coverage between the start of October and the end of March, the deadline to enroll and avoid a tax penalty.
Sebelius offered cautious optimism about the target for enrollment during a June press briefing and pointed out that the sheer size of the risk pool is not the only concern.
“We’re hopeful that 7 million is a realistic target and that we’re going to be driving our efforts toward that kind of enrollment effort,” she said. “And it’s both about numbers and also hopefully getting a balanced risk pool.”
A leaked Sept. 5 memo to Sebelius from another high-ranking HHS official, Marilyn Tavenner, outlined the department’s month-by-month projections for enrollment. Drawing on the estimates from the CBO, as well as “the experience of Commonwealth Care in Massachusetts, Medicare Part D, and conversations with employers, issuers and states,” Tavenner wrote that she expected marketplace enrollment to start slowly but ramp up in December and March, the months with deadlines.
Tavenner’s memo predicted 3.3 million people to have enrolled by Dec. 31, rising to 7.066 million by March 31.
Remember, the estimates and targets from the CBO and Tavenner happened before the healthcare.gov website made its dysfunctional debut. That was not part of the equation.
On Sept. 30, the night before the exchanges opened, an NBC reporter asked Sebelius, “What does success look like?”
“I think success looks like at least 7 million people having signed up by the end of March 2014,” Sebelius said.
The next few weeks were not pretty. The online federal marketplace wasn’t ready, with big kinks preventing lots of people from buying plans.
The Obama administration considers people “enrolled” if they select a plan, not necessarily whether they paid for it.
Couching it
HHS and White House spokespeople directed us to recent statements by administration officials whose answers about the 7 million goal mirror Sperling’s.
For example, senior adviser Dan Pfeiffer said on ABC’s “This Week” on Nov. 3: “Well, that’s a goal that the CBO said is what they thought would happen. Our goal is to get as many people done as possible.”
The position, HHS spokeswoman Joanne Peters said, has been the mix of people is more important than the number. She pointed to Sebelius’ June comments and a late November post by Wonkblog’s Ezra Klein, who said White House officials told him as he reported a July story they defined success as “a function of the mix of people in the exchanges — the ‘ratio’ — rather than the number of people in the exchanges.”
A good health mix in each risk pool is crucial to control costs, and sick people who require more care “are most likely to sign up and do so early,” said Gail Wilensky, an expert on the health care law who was the director of Medicaid and Medicare under President George H.W. Bush.
Obama’s officials are not backtracking so much as they are “realizing that factors are coming into play that weren’t expected,” said Timothy Jost, a Washington and Lee University law professor who is an expert on the law.
“I really think it’s still possible by March to get 7 million,” Jost said, adding that it’s “meaningless” that there are not as many people signed up by the end of the year as once projected.
Other experts, such as Stan Dorn, a senior fellow at the Urban Institute, have been quoted as saying the federal marketplace will function properly even with as few as 2 million enrollees.
“Everyone’s been trumpeting this 7 million target,” Dorn told USA Today. “I think they can fall well short of it and still be on their way to a very successful program.”
Our ruling
Sperling denied the administration had a “magic number” for how many people it wanted to see enrolled for health insurance coverage.
He has a point that the mix of individuals signing up is likely more important than the raw number.
But the Obama administration has used a number — 7 million by the end of March — in the past. There’s no denying that.
We rate this claim Mostly False.
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