PPACA sign-ups rise to 6 million after deadline extended

December 18, 2015 at 10:21 AM
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(Bloomberg) — About 6 million people have signed up for health coverage that will take effect on Jan. 1 in the states that use the HealthCare.gov enrollment system the Centers for Medicare & Medicaid Services (CMS) said Friday.

That's up from about 3.4 million people who had signed up for Patient Protection and Affordable Care Act (PPACA) coverage through the federal system at about the same time last year, CMS officials said today on a conference call. It's difficult to compare the enrollment periods directly because sign-ups for the PPACA exchange, also known as Obamacare, began on different dates this year and last year.

The current 2016 open enrollment period started Nov. 1 and is set to end Jan. 31.

The 2015 open enrollment period started Nov. 15 and ended Feb. 15.

This is the third PPACA annual enrollment period. Insurers, regulators and PPACA exchange managers developed the enrollment period system, which limits consumers' ability to buy coverage on a guaranteed-issue basis to certain months of the year, to discourage healthier consumers from waiting until they get sick to pay for coverage.

Sign-ups this year will provide an important indicator of how PPACA is faring as the 2016 election approaches.

"These numbers tell an important story about a vibrant, healthy, growing marketplace," Andy Slavitt, acting administrator of CMS, said on the conference call. "It's clear now that many people have been waiting to purchase coverage until this enrollment cycle."

The PPACA exchange system can help consumers sign up for Medicaid and health public health coverage as well as for private health insurance.

The figures released Friday include only sign-ups for commercial health insurance, and only for sign-ups in the 38 states that use the HealthCare.gov enrollment system. The figures don't include sign-up information from states such as California and New York that have their own state-based exchange enrollment systems.

Heavy demand

Earlier this week, HealthCare.gov managers extended the deadline to buy health coverage with a Jan. 1 start date to Dec. 17, from Dec. 15. System managers said they made that move because a surge in demand at the HealthCare.gov website kept some consumers from getting through to purchase plans. Many states that run their own shopping systems — including New York, California, Maryland and Minnesota — also delayed their deadlines. Most people can buy policies that start later in 2016 until the end of January.

Health and Human Services (HHS) Secretary Sylvia Mathews Burwell has said the U.S. expects about 10 million people will be enrolled in individual marketplace plans throughout the country by the end of next year, up from a 2015 year-end projection of 9.1 million. PPACA set up marketplaces to buy coverage and offers some people subsidies to help them afford it.

Higher penalties for going uninsured also may be persuading more people to purchase coverage. The penalties start at $695 and can reach thousands of dollars for families with higher incomes. For a typical family of four with an income of $100,000, the penalties could cost about $2,000.

About 34 percent of the uninsured are in households where the cost of a low-level "bronze" plan would be less than or equal to the penalty, according to the Kaiser Family Foundation.

Employer-provided plans

Burwell's projection for how many people will buy PPACA health plans this year fell short of some expectations, in part because more people are staying in employer-provided health plans. In another sign of trouble for the PPACA exchange system, UnitedHealth Group Inc. (NYSE:UNH), the largest U.S. health insurer, has said it may stop selling exchange policies because it's losing money on them.

Kevin Counihan, who oversees the marketplaces at CMS, said the government is seeing signs that more individuals are shopping for coverage for the first time. That could improve results for insurers that sell PPACA policies.

Charles Gaba, who tracks enrollment at ACASignups.net, said Friday's data probably puts CMS ahead of Burwell's projection. When the entire country is counted and people are automatically renewed, he figures about 11 million to 12 million people will have signed up.

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