ObamaCare Exchange Enrollment Is Shrinking, Top Insurers Say

Aetna's (NYSE:AET) ObamaCare exchange statistics should clear up any doubt as to why the Obama Administration has been tight-lipped about enrollment since celebrating 8 million sign-ups in mid-April.

Reality, evidence suggests, could require quite a come-down from those lofty claims.

The nation's third-largest health insurer had 720,000 people sign up for exchange coverage as of May 20, a spokesman confirmed to IBD. At the end of June, it had fewer than 600,000 paying customers. Aetna expects that to fall to "just over 500,000" by the end of the year.

That would leave Aetna's paid enrollment down as much as 30% from that May sign-up tally.

"I think we will see some attrition ... We're already seeing it. And we expect that to continue through the end of the year," CEO Mark Bertolini said in a July 29 conference call.

It's not clear how representative Aetna's experience is of broader exchange trends, or whether its projection may be too conservative. (If it were representative, a similar 30% decline would drop ObamaCare enrollment to 6 million or less.)

Still, as one of ObamaCare's largest players, participating in exchanges in 16 states plus D.C., Aetna's experience provides a pretty good window into what is happening across the country, and there are other indications that enrollment has turned down.

Cigna (NYSE:CI) said that it expects its individual market customers, including more than 100,000 in the exchanges, to "move from 300,000 down to 280,000 in that range," Cigna CEO David Cordani said in a conference call.

Other major insurers danced around questions about attrition on recent earnings conference calls, but none denied that it was occurring.

Another data point comes from Washington, the only state that didn't report sign-ups to HHS until they paid an initial monthly premium. As also pointed out by Charles Gaba of ACASignups.net, the state's exchange had 164,062 paid enrollees as of April 23. But the state reported 156,155 people enrolled as of June 1.

The gap between the high watermark of sign-ups and the number of current premium-paying customers reflects both those who never sent in a first payment and those who stopped paying for any number of reasons. For some, finances may have been too stretched. Some may have gotten fed up with high deductibles, and others could have switched plans so they wouldn't have to switch doctors. Still others may have found a job that came with health benefits, or others lost income and qualified for Medicaid.

ProPublica reported that HealthCare.gov has seen more than 1 million transactions since the extended open-enrollment period, though it's not clear how many represent new customers as opposed to people reporting a change in income, for example.

People who have major life changes, such as losing employer coverage, can still get insurance outside of open enrollment.

"A big question is whether new members will offset attrition," wrote ProPublica's Charles Ornstein.

The incoming evidence suggests that attrition is winning.