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Tick, tick, tick: No drama for Obamacare enrollment deadline

People sit with an insurance advisor as they sign up for Obamacare in Miami.
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People sit with an insurance advisor as they sign up for Obamacare in Miami.

A strong wave of people aiming to beat Sunday's deadline for Obamacare sign-ups in much of the United States were phoning insurance brokers, logging onto HealthCare.gov and other government health exchanges sites, and attending enrollment events.

While that surge echoed last year's sharp uptick in health insurance plan selections at the end of Obamacare's first season, there is also markedly less drama surrounding the close of open enrollment this time around, with business proceeding in a matter-of-fact fashion.

Just after 2 p.m. Friday, the U.S. Health and Human Service Depatrment's media Twitter feed announced, "More people are visiting HealthCare.gov right now than have come to the site since December 15."

Despite that traffic, the federally run insurance marketplace, which spectacularly melted down from technological flaws after its Oct. 1, 2013, has minimized the problems that marked its chaotic release. Yet there were still a few hiccups: On Saturday, an HHS spokesperson acknowledged that "intermittent issues" has prevented some consumers from completing their applications.

HealthCare.gov, which now serves 37 states, had nearly 7.75 million customers who had selected or been automatically re-enrolled for 2015 plans as of Feb. 6. Open enrollment began Nov. 15.

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Friday's traffic level suggests HealthCare.gov alone will easily match the roughly 8 million Obamacare sign-ups see in the entire nation at the close of the first open enrollment in mid-April 2014.

The other Obamacare exchanges being run by 13 states and the District of Columbia already had signed up at least another 2.6 million or so people as of Wednesday.

While deadlines in most U.S. states is Sunday, people in the majority of the country will be allowed to finish the application and plan selection process for several days or more as long as they have begun applying by Sunday.

HHS Secretary Sylvia Burwell said Friday that officials in the next two weeks will decide whether to grant a special enrollment period for 2015 plans to people who find out for the first time that they face a tax penalty for not having insurance last year.

Such a move would come in recognition of the fact that some people will realize they owe that fine only when they file their 2014 tax returns, after Sunday's deadline for obtaining coverage for 2015 has already passed.

Without a waiver to obtain insurance after that deadline, people who were uninsured last year and for 2015 would pay a fine equal to as much as 1 percent of their taxable income in 2014, and then pay a penalty equal to as much as 2 percent of their income when they file their taxes next year.

Enrollment projections

HealthCare.gov website
HealthCare.gov

Charles Gaba, who runs the Obamacare enrollment tracking site ACASignups.net, currently is predicting that total enrollment nationally will end up being 12.5 million.

"I'm pretty confident it's going to be at least 11.5 million," said Gaba. The Congressional Budget Office has projected 12 million people will be enrolled in Obamacare plans in 2015.

For enrollments to be considered official, a customer must pay for their first month's premiums. As of yet, there are no official paid enrollment tallies for 2015 plans.

Gaba said he has been surprised by the large number of sign-ups so far in Florida and Texas, two big, Republican-led states whose opposition to Obamacare led to their decision not to run their own health insurance exchanges. Florida has had almost 1.4 million sign-ups, while Texas has topped 1 million.

"The irony here is that these states have been fighting against the law, and they're the ones that are benefiting the most," Gaba said.

In addition to the government-run exchanges on Friday, online insurance broker GoHealth also was seeing "very very big" traffic, said Michael Mahoney, senior vice president of marketing at GoHealth.

"We're seeing the same spike right at the end that we did last year," Mahoney said.

Mahoney said that traffic to GoHealth's telephone call center became so heavy as of Thursday that the center began directing people to the company's website to sign up for health plans there.

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"We thought the spike would come earlier in the week," he said. "Every customer...just thinks, 'It's Friday, I gotta take care of that thing.' "

That "thing" is the legal requirement, now in its second year, that nearly all Americans obtain some form of health coverage or be subject to a tax penalty. This year, that Obamacare fine has grown to the larger of $325 per adult or 2 percent of taxable household income. That's significantly higher than the penalty of $95 per adult or maximum of 1 percent of taxable household income that the uninsured face for not having gotten coverage last year.

Play or pay

An official at California's Obamacare exchange, which last year was the Obamacare state leader with 1.2 million plan selections, suggested the penalty is playing a large role this year in driving enrollment.

"They are facing penalties, which is ringing a bell," said Dana Howard, spokesman for the Covered California exchange. "That's a big chunk of change which will affect people, and I think that the penalties here, which are significant, is making people take people take a second look at this, and saying, 'I think it's time,' and we're hearing that."

Howard said that from Friday into Sunday "up and down the state you're going to find hundreds of these events doing enrollments." On Tuesday, Covered California handled 13,000 plan sign-ups, and then saw a 30 percent increase in sign-ups the following day, Howard said.

He also noted that the state is better equipped to deal with customer demand this year, with the number of enrollment counselors doubling to 6,000 and the number of insurance agents handling Covered California plans increasing to 14,000 to 10,000.

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While the official deadline for sign-ups was Sunday, Covered California has announced that people who are in the process of applying for coverage as of Sunday night will have until next Friday to complete their plan selections, as long as they work with an enrollment counselor or insurance agent to do so. That grace period will give the exchange a better chance to hit its target of adding 500,000 new customers this year.

Peter Lee, executive director of Covered California, said the exchange would also consider having a special enrollment period soon to allow people who didn't get coverage to do if they had not understood they faced a tax penalty for failing to enroll.

Lee told National Public Radio that Covered California will look "actively" at the people who may not have understood they were exposed to a penalty, and explore the possibility of letting them sign-up in 2015 plans.

"This is a major issue and we're going to be looking at this in the next week or two," Lee told NPR.

Deadlines, sort of

Massachusetts's state-run exchange on Friday extended its deadline, giving residents until Feb. 23 to complete an application and select a plan. The extension is being granted in light of the series of serious snowstorms in the state.

Federal officials have said that people who were "in-line" to complete applications on HealthCare.gov as of Sunday night's deadline will also be given a grace period to finish, as was done last year. New York State's exchange on Friday said those who begin their applications by Sunday will have until Feb. 28 to complete them.

"I do think that states will bend over backwards to use every possible means to get people enrolled this year," said Dan Mendelson, CEO of the Avalere Health consultancy. "The more enrollments these states have are positive both for individuals as well as for their own political fortunes."

Not all people trying to beat the enrollment deadline were using the government-run exchanges.

Financial help, but...

Mike Krucek, an insurance broker in the Chicago area, said that about 10 percent of his customers use HealthCare.gov to enroll in a plan, and they have found "the website worked a whole lot better this year."

"Ninety percent will just go directly, with me, through a carrier," Krucek said, adding that the off-exchange enrollment process process is "much, much quicker" for his customers.

However, he said that in some cases, when he and customers have used HealthCare.gov's call center, they've had to call back after getting a customer-service representative who had "given out completely erroneous information."

But, "I have seen is that you will get people who know what they're doing," he said.

The vast majority of Krucek's customers earn too much money to qualify for the federal subsidies available to low- and medium-income earners to help pay for plans they buy on the government-run exchanges.

This year so far, the average subsidy for HealthCare.gov customers is $268 per month. And 87 percent of the exchange's customers have qualified for such help.

On March 4, the Supreme Court is scheduled to hear a court case challenging the legality of subsidies issued through the federal exchange. Plaintiffs in that case claim the ACA only allows subsidies for customers of state-run insurance marketplaces.

If the high court rules in the plaintiffs' favor in June, up to 7 million or more people who enrolled in HealthCare.gov plans would lose financial assistance worth billions of dollars annually. Experts have predicted that many, if not most of those people would drop their insurance coverage because it would no longer be affordable without the subsidies.