Whatever the ultimate verdict, many experts are predicting a sluggish start as consumers take time to weigh their options under the Patient Protection and Affordable Care Act's broad new system of health plan marketplaces, standardized benefits, consumer protections and premium subsidies.
“I would expect enrollment to be quite slow in October, and then ramp up toward the end of the year,” said Larry Levitt, senior vice president for special initiatives at the Kaiser Family Foundation. And since plans don't start providing coverage until Jan. 1, there should be no rush, he said. “October seems like a good month for window shopping.”
Jessica Barba Brown, national communications director for Enroll America, a pro-ACA group, also forecasted low enrollment numbers at the outset, followed by a spike when the actual coverage starts in January. The organization has targeted 10 states—mostly ones led by Republicans opposed to the ACA such as Florida, Michigan and Ohio—for an aggressive enrollment campaign.
“This is a marathon, not a sprint,” Brown said. “Right now we're in the information phase, helping people to understand what these plans cover and what financial help is available to them.”
In an August poll conducted by the Kaiser Family Foundation, consumers said they're most likely to trust information about the ACA when it comes from doctors and nurses, as well as from federal and state agencies.
Louisiana Insurance Commissioner Jim Donelon said his department is gearing up for a flood of consumer questions about the exchanges. Louisiana has a federally facilitated exchange and state Republican leaders have been vehemently opposed to the reform law. But Donelon said he and his staff will handle consumer concerns directly rather than forward them to HHS, unlike in some other GOP-led states.
“We consider it our responsibility to assist folks the best we can,” said Donelon, calling the ACA's complexity “mind-boggling.”
Federal officials hope an HHS report released last week showing lower-than-expected premiums and ample plan choice in the 36 states with federally facilitated exchanges will go a long way toward quelling consumer concerns about affordability and choice in the new markets.