Health and Science

Obamacare 'paid' enrollment drops to 9.9M

The number of people covered by Obamacare plans nationally fell below 10 million at the beginning of this summer, but still was about 800,000 people above the official goal that federal officials have for the end of the year.

As of June 30, about 9.9 million people were paying for coverage they purchased through government-run Obamacare health insurance marketplaces, the federal government revealed Tuesday. The drop-off mirrored a similar decline in enrollments seen last year, the first in which people had Obamacare coverage.

The new tally is down from the 10.2 million paying Obamacare customers reported as of late March, and from the 11.7 million people who actually signed up for coverage as of February, when open enrollment in the plans closed.

A customer for heath insurance under the Affordable Care Act sits with an advisor with UniVista Insurance in Miami.
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The Obama administration said late last year that it had a goal of 9.1 million "effectuated," or paid enrollments by the end of 2015. Enrollment is official only when a customer makes their first month's premium payment.

The U.S. Health and Human Services Department on Tuesday said that the current tally of 9.9 million paying customers is "consistent" with the department's year-end goal.

"Consumers from coast to coast are continuing to show how important health coverage is to their families," said HHS Secretary Sylvia Burwell. "Millions of Americans are benefiting from the peace of mind that comes from having quality coverage at a price they can afford as they access coverage through the Affordable Care Act."

Officials also said that as of the end of June about 423,000 customers had their coverage for 2015 terminated because they failed to provide sufficient documentation of citizenship or immigration status required to be eligible for Obamacare plans.

Another 976,000 households have had adjustments made to the federal subsidies they receive to help pay for their Obamacare plans' premiums, and/or to the assistance they get in paying for out-of-pocket health expenses, officials said. Both the subsidies and cost-sharing aid are tied to people's annual income levels, and can be adjusted if a household's self-reported income differs from data showing actual income.

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Officials have said that downward trajectory in overall paid enrollment is to be expected.

They have said they expected enrollment numbers to change over time "as consumers find other coverage or experience changes in life circumstances such as employment status or marriage, which may cause consumers to change, newly enroll in, or terminate their plans." Others have lost coverage because of questions about their citizenship or immigration status not being addressed, or dropped out because they no longer considered the coverage affordable.

Last year, which was the first for Obamacare coverage, paid enrollment ended up being about 6.4 million, which was down from the 8 million or so people who had signed up during open enrollment earlier in 2014.

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Of the current tally, most of the enrollments, 7.2 million people, came from the federally run Obamacare exchange, which serves 37 states. The remaining 2.7 million enrolled through state-run exchanges.

About 84 percent of all Obamacare customers—8.3 million people—received received a subsidy, or tax credit, to reduce the cost of their monthly premium. Officials said that the average subsidy was $270 per month. Subsidies are available to people who have incomes between one and four times the federal poverty level, or $11,670 and $46,680 for a single person.

HHS noted Tuesday that 9 out of the 10 states with the highest rates of consumers getting Obamacare subsidies were states that as of June 30 had not expanded their Medicaid programs to allow most poor adults who earn below $15,654 annually for an individual to enroll in that government-run health coverage program. Mississippi, the leader among those states, had more than 94 percent of its Obamacare customers receive subsidies.

More than half of customers nationally, or 5.6 million people, also received federal assistance paying for medical costs that are not covered by their insurance plans. That cost-sharing help is available to people with low incomes who enroll in so-called silver Obamacare plans, which tend to be the second-least expensive types of plans on the exchanges.

Obamacare's next open enrollment season for 2016 plans begins Nov. 1, and will run through Jan. 31. Experts have predicted that getting additional people to sign up for health plans on the government-run marketplaces could prove more difficult this year and in the future, because many people who were eager to get coverage have already signed up, while the remaining uninsured may be disinclined to enroll or feel the plans are not affordable.

However, the minimum penalty for failing to have some form of health coverage will rise considerably in 2016, and could motivate some bystanders to sign up.

That penalty, which this year is the higher of 2 percent of adjustable gross household income or $325 per adult, rises next year to the higher of 2.5 percent of household income or $695 per adult.