HHS Secretary Sylvia Mathews Burwell says the tally of 12.7 million people who signed up for 2016 coverage through the insurance exchanges means the Affordable Care Act has created “a product that people want and need.”
That figure is well below the expectations set before the exchanges launched in 2014, but the plans have allowed millions of Americans to get comprehensive medical coverage and contributed to the lowest uninsured rate in the U.S. on record. Now the Obama administration has to ensure that the risk pool is evening out so that premium rates will stabilize and health insurers will remain interested in selling the plans.
Insurance executives and state officials are griping publicly about the state of the marketplaces. UnitedHealth Group fired the opening salvo in November when it said it may exit the exchanges next year because of heavy losses. UnitedHealth expects to lose approximately $1 billion on its 2015 and 2016 exchange plans. The company's criticisms include that the CMS has allowed consumers to abuse special enrollment periods, skewing the risk pools.
The preliminary enrollment numbers released last week fall within the government's previously stated expectations of 11 million to 14.1 million.
The figure will recede a bit as some consumers who signed up fail to pay premiums or switch to other forms of coverage. The administration predicts there will be 10 million paying exchange members by the end of 2016. The Congressional Budget Office recently lowered its estimate of 2016 exchange enrollment to 13 million from 21 million.
Some not-for-profit Blue Cross and Blue Shield insurers, too, expect sizable deficits on the plans for 2015, and North Carolina's insurance commissioner has questioned whether the ACA has harmed the state's insurance markets.
But in many areas of the country, especially in Democratic-led states, the ACA's open enrollment has become routine. “People are pretty positive about it,” said Jim Moore, a Pacific University political science professor who follows the ACA in Oregon. “It's become a normal thing now.”