California, Washington shine during special Obamacare sign-ups

Now that's a West Coast offense!

Two states that run their own Obamacare markets—California and Washington—are blowing away the much-larger, federally run HealthCare.gov when it comes to signing up customers during a tax season grace period. That special enrollment offer is open to people who only just learned they owe a fine for not having health insurance last year.

Through last Friday, a total of more than 38,700 people selected health plans during special enrollment in California and Washington, officials said. Most of those enrollments came from people subject to the fine for lack of coverage in 2014, although an unknown share of Washington's tally signed up for other reasons.

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The two states' total of fine-related sign-ups is possibly well more than half of the 68,000 or so people who signed up through April 13 on HealthCare.gov—where 36 states are participating in the special enrollment season.

Obamacare supporters had called for a special enrollment period this year because they were worried that too many people remained unaware of the penalty for not having health insurance, and too many would be unable to enroll by the time they became aware of it.

Open enrollment in Obamacare plans closed in mid-February—two months before the end of the first tax season to impose fines for lacking health coverage. Up to 6 million people this tax season were expected to pay fines equal to the greater of $95 per adult or 1 percent of taxable household income. Those fines increase for 2015 coverage to the greater of $325 per adult or 2 percent of taxable household income.

The fines are deducted from a person's tax refund, or, in fewer cases, added to what a person owes the Internal Revenue Service.

A healthcare specialist helps people select insurance plans at the Affordable Care Act Enrollment Fair at Pasadena City College in Pasadena, California.
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A healthcare specialist helps people select insurance plans at the Affordable Care Act Enrollment Fair at Pasadena City College in Pasadena, California.

The difference in the states' performance with HealthCare.gov is striking.

During the special enrollment season, HealthCare.gov signed up less than 2,000 people per participating state as of April 13, according to its most recent data.

In contrast, California by April 12 alone signed up 22,659 people specifically for the penalty-related waiver, which is equal to as much as 33 percent of HealthCare.gov's tally for all 36 participating states.

Washington state signed up more than 16,000 during special enrollment for people who are either subject to the penalty for last year, or who had technical problems signing up during open enrollment, officials said. Washington did not break out subtotals for those groups.

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A spokesman for the Centers for Medicare and Medicaid Services, which runs HealthCare.gov, did not immediately respond to a request for comment.

Dana Howard, a spokesman for Covered California, that state's Obamacare marketplace, noted that the exchange was one of the first to announce and start its special enrollment period, and that the marketplace has aggressively promoted the offer in both free and paid media.

"It seems to be paying off," Howard said.

"Covered California realized very early on that there was going to be this kind of surprise, almost this sticker shock for taxpayers who didn't understand fully this concept that your tax liability is now directly intertwined with your health care, and this is new to millions of people," Howard said. "They get the wake-up call when they get their taxes."

Asked why Covered California was outpacing HealthCare.gov states, Howard said, "I truly do not have an answer for you about what HealthCare.gov may be doing."

Michael Marchand, spokesman for the Washington Health Benefit Exchange, that state's insurance marketplace, said officials suspect that a number of people who were uninsured in 2014 had an "unwelcome surprise" that their tax penalty is 1 percent of household income, and not $95.

HealthCare.gov's special enrollment period, which began March 15, runs through April 30, as does California's, which began Feb. 23. Washington state's grace period, which began Feb. 17, ended last Friday.

"I'm concerned about slowing enrollment," said Dan Mendelson, CEO of the Avalere Health consultancy, when asked about HealthCare.gov's performance during the grace period. "Momentum is very important for a program like this."

"Part of the issue is that the penalties are not high enough to motivate many people to go out and purchase insurance," he said.