Going to ask that you read all of this before replying.

Time Magazine has run a detailed piece on Accenture. I definitely recommend people read it. Certainly, Accenture has done a great job. They've cleaned up a major mess. They're also dealing with the weight of the mess from late last year - as one example, the appeal process for enrollment errors has been largely manual and error prone, though no one can blame Accenture for that.

While Time focused on the CGI->Accenture story, they did mention Accenture's reaction to key people, such as Sebelius (they felt she was nearly useless) and Obama ( had the right instincts but ultimately was so aloof from the people and facts that it was little wonder the entire thing was a failure to begin with). And let's not forget that the administration "passed off" manual processes to insurance companies. Forgetting politics, this administration failed miserably in so many areas.

A story that hasn't gotten enough attention at the national level is the problem of state run exchanges in Oregon, Maryland, Minnesota, Vermont, and Mass. (though from what I've read, Oregon is the worst of the lot). Some state-run exchanges have done pretty well but these have not, and there's been a large amount of vendor finger pointing.

I'm pretty sure the automated payment piece (that will directly transfer Obamacare subsidies to insurance companies) isn't yet in place. If it is I'll stand corrected. The last I heard, a temporary system was only recently put in place for insurers to calculate how much in federal payments they’re owed. So jury is still out on that one.

OK, for the numbers (the four million), that's a number proclaimed by the president and not verifiable. The Washington Post has already given our president a double round of 4 Pinocchios for large exaggerations regarding the numbers.

I'm pretty sure you know how the "rest of the world" counts enrollment. Right now, the consensus from state insurance commissioners is that 1 in 5 have not sent in a payment. So that number is likely closer to 3.2 million.

Some of those 3.2 million were people who lost their insurance late last year and were thrown onto the exchanges (where some found better plans, some found more expensive plans, and some basically broke even). And some of those 3.2 million were people who were going to be Medicaid renewals anyway. The percent of the "young/healthy" people is down around 22-25%, far below the 40% they needed.

I will be surprised (actually, impressed) if they have a TRUE number of 4.5 million by end of March. But even that, combined with bad mix shift for the risk pools, is going to spell higher premiums. Bet on it. And right now, you have a dozen Democratic Senators up for re-election in November who are scared to death.

And what no one seems to be reporting is that the rate of monthly growth has slowed.

In December they got about 1.6 million
In January , about 1.1 million (and January was a longer reporting month)
For February they're reporting about 700,000 so far. Given we're almost at the end of February, I don't see that number going much higher than 800,000.

See a trend?

And finally - you might be aware that Obama signed an executive order (once again, re-writing a law) that pushes back the employer mandate for one year for companies between 51-99 employees (or 50-100, I forget the actual range). This in itself flies in the face of the messaging from the White House that things are better. It also delays a large # of employees who will lose their plans until after the 2014 mid-term elections. But it gets worse. For a company to be eligible for the delay, they must sign a document (administered by the IRS) that they did not adjust their workforce size to become eligible - under penalty of perjury. Guess who gets to determine if the employer is telling the truth? Yes, a re-write of the law, without going through Congress. There is no need for me to provide commentary - that one speaks for itself.