Enrollment groups bank on late Obamacare surge

The Arizona Alliance for Community Health Centers is pushing its affiliated Obamacare enrollment groups to increase shifts for their outreach workers as the three-month open-enrollment period nears its end.

Last week, the Young Invincibles helped organize dozens of outreach events around the country as part of National Youth Enrollment Day. Those events included a health fair at the Rock and Roll Hall of Fame and Museum in Cleveland and canvassing on college campuses such as the University of Central Florida and Northern Illinois University.

Healthcare providers, insurers, community health centers and not-for-profit groups around the nation that are helping Americans sign up for exchange coverage under the Patient Protection and Affordable Care Act are working overtime leading up to the Feb. 15 open-enrollment deadline. They hope to see a huge sign-up surge similar to what occurred during the final weeks of the first open enrollment last year. They are well aware that many people wait until the last minute to make health-coverage decisions and are stressing the stiffer tax penalty attached this year for not buying a plan.

They are paying particular attention to Republican-led states that have done little or nothing to promote enrollment and have large numbers of uninsured residents, such as Florida and Texas.

“Last year, we saw a real uptick in people coming in last minute wanting to do everything right now,” said Allen Gjersvig, the Arizona alliance's director of healthcare innovations.

“We know that Millennial enrollment is about to surge to much greater numbers,” said Jen Mishory, executive director of the Young Invincibles.

Last week, the Obama administration announced that exchange sign-ups had topped 9.5 million as of mid-January.

That included 7.4 million enrollments through the HealthCare.gov website and another 2.1 million through the state-based marketplaces.

HHS had set a goal of 9.1 million sign-ups, while the Congressional Budget Office has set an estimate of 12 million.

But attrition caused by applicants not paying their initial premiums or dropping out over the course of the year will reduce the enrollment total. During the first open enrollment, HHS initially announced that more than 8 million Americans signed up for private plans through the state and federal exchanges. But that number had fallen to roughly 6.7 million by last November. If there is a comparable attrition rate in 2015, roughly 1.5 million individuals currently enrolled will drop out of exchange plans over the course of the year.

Reform supporters hope there will be a deluge of new enrollments in the final weeks, though experts have predicted that signing up the uninsured will be harder this time because many may be healthier or have higher incomes that make them ineligible for premium subsidies.

Matthew Glass, president of Fidelity Insurance Group, which has three offices in Arkansas, said last Wednesday that he had eight exchange applications sitting on his desk waiting to be processed and more appointments lined up. “We've gotten calls literally from people all around the state trying to get enrolled before the 15th,” he said. “It's really picked up here in the last couple of weeks.”

The last-minute enrollment spike is expected to be particularly robust among the prized demographic of 18- to 34-year-olds. In the first open-enrollment period, that group accounted for 24% of exchange customers during the first two months of operations. That figure shot up to 31% during the final month of the enrollment window. In addition, roughly half of the remaining uninsured adults nationwide are between the ages of 19 and 35, according to a survey released last week by the Kaiser Family Foundation.

There also will be a focus on reaching out to minority communities, particularly Spanish-speaking households, during the final two weeks of enrollment. While sign-ups spiked at the end of the first open-enrollment period across all demographic groups, the surge was particularly pronounced among minority groups. The volume of Latino enrollments through HealthCare.gov rose by more than 30% during the final week of enrollment last year, while sign-ups by African-Americans increased by roughly 25%. The corresponding increase among whites during the final week was only 17%.

Tomas Leon, CEO of the People of Color Network in Phoenix, said there's still widespread confusion about the enrollment deadline and the tax penalties for not buying coverage. Other experts say many Americans don't know about the availability of federal premium subsidies to make coverage more affordable.

Leon said his outreach workers are focusing on the benefits of coverage and the tax penalties, which increase this year to $325, or 2% of income, whichever is greater. His workers tell the people they counsel, “Here are the benefits and here are the penalties,” he said. “You make an informed decision about what's most important for you.”

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