Health and Science

Obamacare sign-ups near 3M as key deadline looms

An insurance agent in Miami discusses plans available through the Affordable Care Act.
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Top federal health officials say they are pleased with both the pace of Obamacare sign-ups so far this enrollment season — which have topped 2.8 million — and the fact that customers appear to be shopping wisely for health coverage this year.

"It's a good start," said Andy Slavitt, acting administrator of the Centers for Medicare and Medicaid Services, the agency that oversees the Affordable Care Act program. "We're feeling good about that progress that we've made so far."

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Slavitt told reporters on Wednesday that the federal insurance marketplace HealthCare.gov is "seeing a surge of interest" ahead of the Dec. 15 deadline to sign up for health plans that take effect Jan. 1. He also said the rate of sign-ups in a number of states is outpacing that seen during the same time last year, when people were enrolling in plans for 2015.

As of Saturday, more than 2.8 million people had signed up for 2016 Obamacare insurance plans sold on HealthCare.gov since open enrollment began Nov. 1, according to CMS. That includes about 800,000 people who signed up just last week, officials said.

About 1 million enrollees were new customers, as opposed to existing customers of HealthCare.gov, which serves people in 38 states that are not operating their own Obamacare marketplaces. For sign-ups to be considered official enrollments, customers must make their first month's premium payment.

"Don't wait. There are only six days remaining before the Dec. 15 deadline," Slavitt said. He noted that HealthCare.gov's call center handled more than 1 million queries from consumers last week, and that similar high volume is expected in coming days.

While the deadline for coverage effective January is Dec. 15, open enrollment continues until Jan. 31. People who do not have some form of health coverage after that date are subject to a tax penalty, which in 2016 will be the greater of $695 per adult, or 2.5 percent of adjusted household income.

Nationally, about 11.7 million signed up for Obamacare coverage for 2015 during the previous open enrollment season, which ended early this year. The actual number of people who ended up paying their first premium was about 10.2 million. The enrollment tally has drifted down slightly since then.

Sylvia Burwell, secretary of the U.S. Health and Human Services Department, has said she expects about 10 million people to be enrolled in Obamacare plans by the end of 2016.

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On Wednesday's call with reporters, Slavitt said that "we believe that there's evidence that consumers are making better choices this year, and they're educated about their options" on the federal exchange.

He pointed to the fact that more than 2 million consumers on HealthCare.gov have used the site's new search tools to look up whether certain doctors or prescription drugs are covered by health plans.

Slavitt also said that people who already had coverage from a HealthCare.gov plan this year "are clearly shopping to get the right plans."

HealthCare.gov automatically re-enrolls existing customers in the same or similar plans if they don't actively shop and re-enroll themselves for the coming year.

But federal health officials and Obamacare advocates have repeatedly urged all current customers to actively shop for plans on the exchanges. That's because many of those customers would be able to save money if they switched from their current coverage.

Slavitt said that "returning consumers can save about $600 in premiums" by coming back to HealthCare.gov to actively shop, as opposed to accepting automatic re-enrollment.

Those savings would be before the consideration of tax credits, or subsidies, which most Obamacare customers qualify for to help reduce their monthly premiums because they have low or moderate incomes.

"The average consumer who comes back to shop and pick plans actually pays less than what they did last year" after tax credits, said Kevin Counihan, CEO of HealthCare.gov.

Counihan has noted that the availability of those subsidies means that 7 out of every 10 Obamacare customers can find plans with premiums of less than $75 per month.

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While Counihan and other officials have noted that the subsidies can make health plans affordable to many people, he and Slavitt on Wednesday highlighted the Obamacare penalty for failing to have insurance.

And they noted that, unlike last year, the Obama administration does not plan to offer a special tax season grace period to enroll in coverage after Jan. 31. Such a grace period was granted during the last tax filing season because many people learned only then, after open enrollment had ended, how much their penalty would be for having not had health insurance in 2014.

The Kaiser Family Foundation, in a report issued Wednesday, said that the average fine paid by a household that is uninsured will be $969 in 2016, up from an estimated $661 per household in 2015.

The foundation also said that the average penalty would be much higher, an average of $1,450, for uninsured households that aren't eligible for Obamacare subsidies because their incomes are too high.

The same Kaiser report said that after tax credits are factored in, 3.5 million uninsured people could buy coverage for 2016 for $0 monthly premiums or plans that would still cost annually less than what they would owe in fines for not having health insurance.

Another 7.1 million uninsured people would end up paying more than their potential fine if they opted for the least-expensive plans sold on government-run exchanges.

Correction: Counihan and Slavitt highlighted the penalty for not having insurance on Wednesday. An earlier version misstated the day.