PASADENA, CA - NOVEMBER 19: A healthcare reform specialist helps people select insurance plans at the free Affordable Care Act (ACA) Enrollment Fair at Pasadena City College on November 19, 2013 in Pasadena, California. The event, sponsored by the Chamber of Commerce and the Los Angeles Association of Health Underwriters, offers one-on-one sessions with insurance experts certified by Covered California to help people enroll for healthcare coverage under the ACA. National Journal

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One of the biggest players in Obamacare's exchanges says 15 to 20 percent of its new customers aren't paying their first premium — which means they're not actually covered.

The latest data come from the Blue Cross Blue Shield Association, whose members — known collectively as "Blues" plans — are participating in the exchanges in almost every state. Roughly 80 to 85 percent of people who selected a Blues plan through the exchanges went on to pay their first month's premium, a BCBSA spokeswoman said Wednesday.

The new statistics, particularly from such a large carrier, help define how many people are actually getting covered under the Affordable Care Act.

The Blues' experience is in line with anecdotal estimates from other insurance executives, who indicated earlier in the enrollment process that they received payments from about 80 percent of people who selected their plans.

The Blues' latest estimate includes policies that took effect Feb. 1 or earlier, the spokeswoman said.

Some health care analysts have suggested that the payment rate could improve later in the enrollment window, as plans had more time to track down consumers who hadn't paid.

Wherever the final number ends up, it will be the real measure of how many people are actually covered through the Affordable Care Act's exchanges. The Obama administration has been releasing the number of people who selected a plan, but says it doesn't have accurate data on how many have actually paid. And consumers don't have coverage they can use until they make that first payment.

If the nationwide payment rate, across all carriers, remains at 80 to 85 percent, the 7.1 million sign-ups Obama announced Tuesday would translate into somewhere between 5.7 and 6 million people who are actually covered.

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This article is from the archive of our partner National Journal.

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