Obamacare enrollment on pace to meet predictions

The latest enrollment numbers from the insurance exchanges show that after the first month of open enrollment, sign-ups are on track to meet or surpass the Obama administration's projection that 9 million to 10 million Americans will buy exchange plan coverage for 2015.

More than 1 million Americans enrolled through HealthCare.gov from Dec. 6 to Dec. 12, boosting the overall total for the first four weeks of the second open-enrollment period to almost 2.5 million. In addition, more than 750,000 people are estimated to have selected or re-enrolled in plans through the 14 state-run exchanges in states including California and New York, plus the District of Columbia.

By comparison, during the first month of open enrollment last year, only 106,185 individuals had enrolled in plans through the federal and state exchanges, many of which experienced severe technical problems.

More than half of those who enrolled between Dec. 6 and Dec. 12 were renewing their coverage, while the rest were new customers.

“What a difference a year makes,” said Katherine Hempstead, director of coverage at the Robert Wood Johnson Foundation. “There's the absence of all the technological problems that made enrollment so frustrating around this time last year. The signs are that people really did value the opportunity to get insurance.”

With open enrollment scheduled to end Feb. 15, Hempstead said the latest numbers suggest the administration will exceed its cautious enrollment goal for 2015. Consumers had to sign up by Dec. 15 to start coverage on Jan. 1, though some states and insurers extended the deadline until later in the month. And many insurers are giving customers extra time to pay their January premiums.

Besides consumer demand, the strong enrollment may be the result of more insurers offering more products, marketing aggressively and keeping premium increases modest in many markets.

In conducting their own marketing for the exchange, insurers have shown they are increasingly comfortable with the marketplace format, Hempstead said. “Once there was an actual customer base in the first enrollment period, the carriers became a much more important part of the information stream,” she said. “They were more visible.”

The CMS has not released data on the number of exchange plan customers who passively allowed themselves to be re-enrolled in their current plan. The latest data also do not include enrollment activity the weekend before the Dec. 15 deadline, when there likely was a surge of procrastinating shoppers.

Sara Collins, a vice president at the Commonwealth Fund, said that while the first month's totals look encouraging, it's too early to make reliable projections. “We really don't have a good sense until the very end of the open-enrollment period,” she said, noting the huge surge in 2014 enrollments in the last few weeks of the previous sign-up period. She added that it will be particularly interesting to see how the auto-enrollment process, which is new for this year, plays out. State and federal exchange officials are actively encouraging 2014 enrollees to return to the marketplaces to shop for potentially better deals.

Avalere Health estimated last week that there will be between 4.5 million and 6 million new enrollees by Feb. 15 in the federal and state exchanges, with total sign-ups on course to reach between 9.5 million and 11.5 million.

On a more skeptical note, Mark Pauly, a professor of healthcare management at the University of Pennsylvania, said, “There's still a long way to go to 9 million.” Regardless of whether the administration's goal is reached, Pauly said, many people still can't afford healthcare coverage and will remain uninsured.

“We'll still be well behind in terms of covering everybody or even close to everybody,” he said. “It's not whether they hit their targets—it's whether we make the kind of dent (in the uninsured rate) that people thought was the purpose.”

Though the enrollment numbers appear strong so far, they likely won't do much to improve public opinion of the healthcare reform law, said Yevgeniy Feyman, a fellow at the conservative Manhattan Institute.

A new survey last week by the Kaiser Family Foundation found the reform law remains unpopular, but specific provisions have broad support. Roughly one-third of respondents said they wanted to repeal the law entirely, while nearly half favored either expanding the law (24%), or implementing it as currently written (21%). The rest either wanted to scale it back or had no opinion. About 75% expressed support for the exchanges, the premium subsidies and Medicaid expansion.

The employer mandate, which takes effect next year for companies with at least 100 workers, was backed by 60% of those surveyed. But only 35% supported the mandate that everyone buy coverage.

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