Health-insurance sign-ups on U.S. exchange top 1.1 million in initial enrollment period
More than 1.1 million Americans signed up for an insurance plan through the federal health-care marketplace during its initial
enrollment period, with more than 975,000 enrolling in December alone, the
Obama administration announced Sunday.
The new figures, which came as the administration reworked its computer
system to extend the deadline for an extra day, until midnight on Dec. 24,
suggest that federal officials are making up some ground after glitches and processing errors made HealthCare.gov
difficult to access and navigate during its first two months of operation.
So far, nearly 2 million Americans — who were either uninsured or had to
change coverage after their existing plans were canceled — have signed up under
the new health-care law on state and federal marketplaces. Roughly 850,000
people have enrolled through the state-run exchanges, according to Charles Gaba,
a Web designer tracking enrollment numbers.
The administration is still far short of the enrollment targets it set just
before the system was launched Oct. 1. The Department of Health and Human
Services had anticipated that 3.3 million people would have signed up
by now, according to a Sept. 5 agency memo.
Still, officials celebrated the end-of-year results.
“We are in the middle of a sustained, six-month open enrollment period that
we expect to see enrollment ramp up over time, much like other historic
implementation efforts we’ve seen in Massachusetts and Medicare Part D,” Centers
for Medicare and Medicaid administrator Marilyn Tavenner wrote on the HHS blog, referring to the nation’s
first health-insurance exchange under Massachusetts Gov. Mitt Romney (R),
in 2006, and the prescription drug coverage expansion enacted during President
George W. Bush’s administration. “In part, this was because we met our marks on
improving HealthCare.gov: the site supported 83,000
concurrent users on December 23rd alone.”
The next critical deadline for enrollment is March 31, after which
individuals face a tax penalty if they remain uninsured.
Some experts on health-care policy say the December surge increases the
possibility that the law could meet federal projections of 7 million
enrollments by March 31, 2014.
“It is starting to track with what people, particularly the Congressional
Budget Office, projected originally,” said Larry Levitt,
senior vice president at the Kaiser Family Foundation. “December is the first
month where federal sign-ups have kept up with state sign-ups, too.”
Senior administration officials have said they expected enrollment to start
slowly after the Web site’s October launch and remain relatively low in
November, before accelerating in December as many Americans sought out plans
that would take effect Jan. 1.
That pattern materialized, although at a much lower level than officials
initially expected. As of Dec. 22, 890,000 Americans had enrolled on the federal
exchange, according to government figures that had not been made public, meaning
that more than 200,000 people chose health plans on Dec. 23 or 24. By
contrast, roughly 137,000 people signed up through the federal system in its
first two months of operation.
Delayed by glitches
At least some of the late-
December shoppers didn’t mean to
procrastinate, but technical issues thwarted their earlier attempts to sign up
for coverage.
Anita Pinser, 62, tried to buy coverage Oct. 1 but finally enrolled in a plan
Dec. 22.
“I kept trying and trying,” said Pinser, a former human resources
professional who lives just outside Charlotte and who was laid off in 2008. “I
called the 800 number and found out everyone was having problems.”
When she saw a posting on Twitter Dec. 22 about the impending deadline,
she decided it was time to give it a final try. “I had my account set up, so all
I really had to do was click on the coverage that I wanted,” she said. “It was
really easy. The only bad experiences I had were the first month, when no one
could sign up.”
But others are still experiencing serious problems with the Web site. David
and Karen Hart live in Santa Rosa Beach, Fla., and both are self-employed. Their
existing Blue Cross Blue Shield policy was canceled in the fall and then
reinstated, but they picked a new plan on HealthCare.gov and paid for it on
Dec. 19.
When he noticed that their payment hadn’t been deducted from their bank
account, David Hart called Florida Blue on Dec. 27; he was told that the
government’s computer system had canceled their plan. His wife spent more than
four hours on a federal hotline Saturday, at which point she was told the
insurer had jettisoned their policy.
“I’m a 56-year-old, and I have had health insurance my entire life. It’s just
astounding that we’ve had to go through this,” David Hart, an artist, said in an
interview. He noted that he and his wife support the new law but have been
dismayed by how federal officials are implementing it. “We think it’s good
policy, but what they’re doing is atrocious.”
By Sunday afternoon, CMS officials were investigating the Harts’
complaint.
America’s Health Insurance Plans spokesman Robert Zirkelbach, whose group
represents insurers, said firms “are working around the clock to process the
high volume of enrollments that they have received from the exchanges. While
there are still some ongoing challenges with the back-end systems, including
so-called ‘orphan records’ where the enrollment files are never received, health
plans are working with CMS to resolve those issues as quickly as possible so
that consumers’ coverage can begin in January.”
The CMS did not release any demographic information about who has enrolled,
including the age breakdown. Those numbers are important, since insurers need a
well-distributed risk pool in the exchanges to keep premium prices in check.
Outreach efforts
The administration is gearing up to preempt any health-care access problems
that may crop up starting next month, publishing online guides on how to
determine which doctor visits and prescription drugs are covered under the new
system.
In a statement Sunday, the CVS pharmacy chain said that its employees “will
provide information to help patients contact the appropriate health plan or
insurance exchange,” and work with insurers and government agencies to “help
minimize disruptions to care whenever possible.”
“In some circumstances and based on clinical considerations, we may also
assist patients with a transitional supply of a prescription to a patient
experiencing a temporary disruption in coverage to support their continuity of
care,” CVS said.
Officials also plan to intensify their outreach to young adults, Latinos,
African Americans, women and other key groups after Jan. 1, they said, through
intermediaries including celebrities, local activists, provider networks,
nurses, doctors, churches, mosques and synagogues.
“We are eager to assist millions more Americans gain the health security
offered by the Affordable Care Act in the weeks and months ahead,” Tavenner
wrote.
Former Vermont governor Howard Dean (D) said on “Fox News Sunday” that
despite the problems of getting young people to sign up, he was confident that
President Obama’s health-care law would be “running a lot more smoothly” by
March.
The former Democratic National Committee chairman, who is also a doctor,
accused critics of overstating the problems. “I think the first year is going to
be more successful than most people think,” he said.
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