The Obama administration may take as many as two weeks before deciding whether to extend open enrollment for consumers who realize they'll face a hefty tax penalty for not obtaining health insurance coverage this year, HHS Secretary Sylvia Mathews Burwell said during a news briefing Wednesday.
Burwell declined to comment during the briefing about factors the agency is considering in its decisionmaking, other than saying it would center on what's best for consumers. For 2015, the penalty is $325 per uninsured person or 2% of household income over the filing threshold. That's up from 2014, when it was $95 per uninsured person or 1% of household income over the filing threshold.
Up to 6 million Americans are expected to pay a penalty for not having coverage in 2014, according to recent Obama administration projections. Most of the uninsured won't actually face the penalty because they'll qualify for an exemption, either related to their inability to afford coverage or some other hardship.
HHS has already announced a special enrollment period ending Feb. 22 for people who had an in-process application on Feb. 15. This group includes the just under 150,000 people who were on the phone with the call center and were unable to complete the application process before the deadline, Burwell said. That number does not include those who had technical issues and were unable to complete their enrollment. HHS has no estimates on the number of folks in this other group. Several state exchanges also have announced enrollment extensions.
As of midnight Feb. 15, 11.4 million consumers selected or were automatically re-enrolled into plans. That includes 8.6 million with plans on HealthCare.gov and about 2.8 million people who got a plan from a state-based marketplace, HHS announced.
Minnesota announced Wednesday that it will have a two-month special enrollment period, starting March 1, for individuals facing tax penalties for not having coverage. Most other state-based exchanges, including those in New York and California, also are considering an additional sign-up period to allow individuals just learning about the financial penalties to enroll in coverage.
Exchange officials have reached out to insurers and determined that they are not worried about adverse selection if a special enrollment period is added, said Peter Lee, executive director of Covered California, on a conference call sponsored by Families USA which supports the Accountable Care Act. “This is a teachable moment,” Lee said, indicating that they'll make a decision next week. “This is the first time ever in our history that healthcare and taxes are totally intertwined.”
State exchange officials also provided some insight into how many customers who initially enrolled in 2014 stuck with their coverage for this year. In New York, 87% of 2014 exchange customers re-enrolled in coverage, according to Donna Frescatore, executive director of the New York Health Benefit Exchange.
In Washington, 93,000 out of 120,000 marketplace enrollees for 2014 still have private coverage this year. Roughly 10,000 of those individuals who dropped out did so because they became eligible for Medicaid coverage, according to Richard Onizuka, CEO of the Washington Health Benefit Exchange.
And in California, of the roughly 1.1 million individuals who were enrolled in exchange plans at the end of last year, more than 940,000 stayed enroll for 2015. Of those who dropped out, 8% did so because they were eligible for Medicaid, according to Lee. And of those that stayed in private coverage, 94% opted to keep the same plan.
“Consumers liked their plans and stayed with them by and large,” Lee said.
HHS' goal for the second re-enrollment period is to have an effectuated enrollment, people who have selected plans and paid for them, of 9.1 million. It may not be until the next open-enrollment period begins next fall that the agency will know if it's reached its goal, Burwell said.
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