President Barack Obama is seeking to give consumers more time and options to enroll in Affordable Care Act health plans, delaying an application deadline and allowing insurers in three states to sign up customers directly.
Consumers can now sign up for health coverage as late as Dec. 23, for policies that would begin Jan. 1, the Centers for Medicare & Medicaid Services said yesterday. Previously, people needed to enroll by Dec. 15 for coverage effective at the start of the year. Customers in Texas, Ohio and Florida can bypass the U.S. website and enroll directly with insurers, the agency said in a blog post.
While 106,185 people were able to select private plans through the government exchanges last month, almost 1 million more abandoned the application process before choosing a plan, in some cases because they encountered website errors and long wait times. Jeffrey Zients, the economic adviser that Obama asked last month to help fix the website’s issues, said the site will work smoothly by the end of November.
“There will not be a magic moment at the end of the month when our work will be complete,” Zients told reporters on a conference call. “The site will be better at the end of the month than it is today and it will continue to improve.”
Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, said the changes to this year’s interim deadline for consumers will require insurers to work fast.
“It makes it more challenging to process enrollments in time for coverage to begin on Jan. 1,” he said in an e-mail. “Ultimately it will depend on how many people enroll in those last few days.”
The online exchanges, where people can shop for private health insurance with the help of government subsidies, are the core of the law’s promise of extending medical coverage to most of the nation’s 48 million uninsured. The U.S. health website covers 36 states while the other 14 states and Washington, D.C., created their own exchanges.
Customers in Florida, Texas and Ohio, three of the largest states relying on the federal website, can shop for health plans and enroll directly with insurance companies rather than using healthcare.gov, Julie Bataille, a CMS spokeswoman, said yesterday in a blog post. The program is intended to test the concept of “direct enrollment.”
The sign-up period for the Patient Protection and Affordable Care Act still runs through March 31, 2014.
Obama also is pushing back the second-year start of enrollment to Nov. 15, 2014, from Oct. 15. That move is intended to give insurers until May 31 to analyze claims from the first year of plans sold under the law, an extension that may potentially stave off premium increases before the 2014 congressional elections.
Technology failings in the government-run exchanges are undermining efforts to attract the broad array of customers needed to keep plans affordable in the long run. Avoiding a large increase in prices next year is “absolutely critical” if Obama wants to preserve his signature legislative achievement, said Ana Gupte, a Leerink Swann & Co. analyst.
“The death of this law would be for health insurance companies to price policies for 2015 in a way that premiums skyrocket,” Gupte said in an interview. “At that point, it’s a death spiral and it’s over. So he needs to do something.”
The young, healthy people needed to balance the cost of care for older consumers aren’t likely to sign up in large numbers until March, said Jonathan Gruber, a Massachusetts Institute of Technology economist who helped design the law.
“This is an important business for them and they want to make smart decisions about how they set their rates,” Gruber said in a telephone interview. “It’s in the nation’s interest they get time to make those decisions.”
The delay in the start of next year’s enrollment gives insurers more time to decide if they want to participate for 2015 and determine what rates they would charge.
Starting the second year of enrollment after the Nov. 4, 2014, congressional elections may be important to a president seeking to hang onto the Democrat-led U.S. Senate and maintain or gain seats in the Republican-led House of Representatives.
“If premiums go through the roof in the first year of Obamacare, no one will know about it until after the election,” Senator Charles Grassley, an Iowa Republican, said in an e-mail. “This is clearly a cynical political move.”
Popularity of the Affordable Care Act known as Obamacare has already fallen to record lows.
A Kaiser Family Foundation survey found that just 33 percent of Americans now support the health-care law compared with 38 percent a month earlier. That’s the lowest support level measured by the foundation since the law’s passage in March 2010, the Menlo Park, California-based nonprofit said.
Some states are reporting that sign-ups have begun to accelerate now that the initial website errors are being fixed. The exchange in California, the most populous U.S. state, said yesterday it has enrolled almost 80,000 people in health plans.
Getting the federal exchange fixed is necessary because almost all Americans are required to have health insurance by March 31 or pay a fine of as much as 1 percent of their income. Most Americans are already covered, either through an employer or government programs like Medicare and Medicaid.
The website should soon be able to handle 800,000 users per day and 50,000 users per hour, “the capacity or volume that was originally intended,” Zients said.
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