Healthcare.gov starts to see enrollment boost, but concerns linger
More than 1 million new customers have signed up for insurance on the federal insurance exchange Healthcare.gov and the site is developing near-deadline momentum, federal officials said Wednesday.
Six days before the Dec. 15 deadline for coverage that starts Jan. 1, acting Centers for Medicare and Medicaid Services Administrator Andrew Slavitt said there has been a "surge of interest" is signing up for insurance.
By the end of last week, 2.8 million people had chosen plans on Healthcare.gov, which serves 38 states that didn't set up their own insurance exchanges. That includes the 1 million new enrollees and an additional 1.8 million who renewed their policies.
CMS warns that it's not fair to compare this year to last year as the enrollment period started two weeks earlier so the weeks don't match up exactly. Charles Gaba, an Affordable Care Act supporter who tracks the enrollment data closely on ACAsignups.net, says the latest numbers are running slightly over his expectations.
Although Slavitt said he was encouraged by the enrollment so far, he refused to say enrollment was on track to meet Department of Health and Human Services Secretary Sylvia Burwell's then-surprisingly conservative estimate that about 10 million people will be enrolled in plans purchased on the exchanges by Dec. 31, 2016.
"There's probably no huge upside to locking themselves into anything at this point," says Katherine Hempstead, director of the insurance coverage team at the Robert Wood Johnson Foundation.
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The administration also says it won't be doing special enrollment periods for people who are shocked into wanting to sign up after they see their penalty at tax time for not having insurance, something they offered this year. Insurers have been critical of the unpredictability caused by these special periods — which are also offered for people in a variety of situations, such as those who move out of state, marry, divorce or lose their job.
Such shock, however, is likely to occur in 2017 as the average penalty for not having insurance in 2016 will be $969 per household, the Kaiser Family Foundation said Wednesday, which is a 47% increase over the average of $661 for not having coverage this year.
The reasons for being allowed to buy insurance outside of open enrollment "have to be tightly defined and well enforced," Hempstead says. If it were "too easy to say you meet one of the conditions," she says, people could say they met them and sign up just because they got sick — which is exactly what insurers don't want to happen.
Costs are a concern keeping some lower-income consumers from buying insurance, says Baton Rouge-based agent Ronnell Nolan, who is CEO of Health Agents for America. Some are facing smaller tax credits and even slightly higher monthly premiums can be too much to afford. One client Tuesday faced a doubling of her premium if she stayed in the same plan, but Nolan says she found a plan with the same premium, but a much higher deductible and cost sharing for drugs.
"Some are just saying I will pay the penalty," Nolan says. "The conversations break my heart daily."
Competition is key to keeping costs down. Last month, United Healthcare raised concerns when it announced it might leave the exchange market after 2016 because of "higher risks and more difficulties" than anticipated. Last week, Cigna CEO David Cordani told Kaiser Health News the company hasn't made money on the exchanges for the past two years.
Slavitt said he's not worried about the long term health of exchanges.
"All the evidence for us, is that the marketplace is strong, vibrant and it's growing," he said.