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October 04, 2016 12:00 AM

HHS says millions are losing out on tax credits for marketplace coverage

Virgil Dickson
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    At least 2.5 million Americans who currently purchase individual health insurance plans would qualify for tax credits if they bought coverage through the marketplace next year.

    On Tuesday, HHS revealed that six states, including California, Florida, Illinois, North Carolina, Pennsylvania and Texas each have more than 100,000 people whose incomes may qualify them for marketplace tax credits. These consumers could buy insurance coverage for less than $75 per month on the exchanges created by the Affordable Care Act.

    HHS said it will target these people in new television, radio and digital ads that will encourage them to sign up during the next open enrollment period, which runs from Nov. 1 to Jan. 31, 2017. HHS has also embarked upon a campaign to enroll younger, healthier people on to marketplace plans.

    The Obama administration has been struggling to get its target number of ACA marketplace enrollees. Experts say that's led to a weaker risk pool. Some experts, however, say more people are covered under the ACA than just through the exchanges, they're just becoming eligible for Medicaid under state expansion efforts.

    An estimated 6.9 million people purchase health insurance in the individual market outside of the ACA exchanges.

    A recent Commonwealth Fund survey found that only 52% of uninsured adults were aware that financial assistance is available through the marketplaces. These same people might have previously been rejected for tax credits because their income level made them ineligible.

    Experts aren't sure whether outreach efforts by HHS will lead to more enrollees. Some people eschewing the exchanges "may feel stigma associated with taking government subsidies and may be opting to stay with basic policies available off-exchange," said Dan Mendelson, president of Avalere Health. Others may not switch because their preferred physician or medication isn't covered, he added.

    Another factor is that people choose off-exchange coverage because they offer features that are increasingly scarce in marketplace plans, such as out-of-network benefits, according to Katherine Hempstead, a senior adviser at the Robert Wood Johnson Foundation.

    Last year, more than 12.7 million signed up for health insurance during open enrollment.

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