First Estimate On Insurance Sign-Ups Is Pretty Darned Small

By Julie Rovner

Published November 11, 2013 at 6:17 PM EST

Mario Ricart , an insurance agent with Sunshine Life and Health Advisors, talks with Naylie Villa about buying insurance under the Affordable Care Act on Nov. 5 in Miami.

The Obama administration later this week will issue much anticipated enrollment numbers for the first month of the Affordable Care Act.

But Monday afternoon The Wall Street Journal reported that fewer than 50,000 people have signed up for health insurance in the federal health exchange the during October. Even with the administration's efforts to lowball expectations in recent days, that's a pretty small number. And the while the White House won't confirm it, it's not specifically denying it, either.

So judging by the last several weeks, that either means they still don't want to tell us, or they still don't know the actual number.

Here's a quick Q and A on what that 50,000 figure might mean.

So 50,000 people, give or take, signing up for health insurance through the federal health exchange. How many people were expected to sign up this first month?

The leaked number we heard was just a little under 500,000. Of course that was before it became clear that the federal exchange pretty much didn't work.

As you may remember, people couldn't get on, of if they got on they couldn't register, and if they could register they couldn't pick a plan, and if they could pick a plan the information couldn't quite make it to the insurance companies.

Even Health and Human Services Secretary Kathleen Sebelius warned everyone that the numbers would be pretty small for this first month. And if these particular numbers aren't quite right, don't expect the actual numbers released later this week to be a whole lot different.

These numbers don't represent everyone who has signed up, do they?

That's right, these are just the folks who managed to get through the troubled federal exchange.

On Monday Avalere Health, a health policy think tank, released a study that found another 50,000 people have enrolled in private coverage through 12 of the state exchanges that have reported information so far. Note that the largest state exchange, California, hasn't reported any enrollment numbers yet, but it has logged 2.5 million visits to its website.

But these numbers are well short of what the program will need to be deemed a success, isn't that the case?

It's really hard to tell yet.

The Obama administration has been touting what turns out to be something of a questionable statistic from Massachusetts about a slow start to that program in 2006. (Massachusetts' health law is the program on which the Affordable Care Act is based). But the Avalere study points out that these first-month enrollment numbers are not that far off from the enrollments in the Medicare prescription drug law in the early days. And that program turned out just fine.