Jayne O’Donnell | November 11, 2014
Federal regulators announced Monday that they are predicting a lower number of people will enroll in the Affordable Care Act exchanges for 2015 than the Congressional Budget Office predicted earlier this year.
HealthCare.gov and state exchanges went live Sunday night for consumers who want to browse and compare plans before open enrollment starts. Once people start buying plans on Saturday, Department of Health & Human Services officials said they are expecting just 9 million to 9.9 million enrollees for 2015, far below the 13 million the CBO projected would have insurance and pay their premiums through the federal and state marketplaces by 2015.
CBO’s estimates were made before final data on 2014’s open enrollment were completed. CBO also projected enrollment in exchanges would reach 25 million by 2017. That was based on CBO’s assumption that along with the 13 million people in 2015, there would be 24 million signing up for 2016, and 25 million in 2017.
HHS Secretary Sylvia Burwell, the former head of the Office of Management and Budget, explained that the difference in HHS and CBO’s estimates hinge largely on a difference of opinion on how long it will take for enrollment to ramp up.
HHS’ new number may also be “a conservative estimate” because it doesn’t explicitly include people moving from employer-sponsored insurance, which was part of the CBO methodology, said Katherine Hempstead, director of coverage at the Robert Wood Johnson Foundation. “That migration is definitely taking place to some extent, particularly in the small group market.”
HHS’ estimated rate of people who will enroll for the first time, based on who enrolled last time “could be optimistic if the uninsured are as a group harder to enroll this time around,” she said.
The 7.1 million people who kept their plans of the 8 million who enrolled last time is encouraging and “may be the most important factor for the long-term viability of the marketplaces,” she said.
In a speech Monday, Burwell urged consumers to disregard the Supreme Court’s Friday decision to reconsider a lower court’s ruling that upheld the ACA’s system of subsidizing insurance coverage.
“Nothing has changed,” Burwell said in a meeting of the Center for American Progress. “The law stated that tax credits are important – we believe that is the intention of the law.”
Despite the upcoming Republican takeover of the Senate and rumblings about dismantling the ACA, Burwell said “the idea of repeal is not something this Administration would let happen. What we will do is work to improve it.” She said she hopes the talk will “shift to substantive conversation” on things both parties can agree on, especially the importance of affordability and accessibility of coverage and medical care.
HHS also announced Monday that 120,000 households that didn’t respond to repeated requests for updated income information so have had their subsidies adjusted and will face an increase in costs of new plans. Another 112,000 people will have their coverage terminated because of outstanding questions about their immigration status, although they can have their plans reinstated. About 4,500 returned after the deadline and are eligible to have their Marketplace coverage restored.
These numbers only apply to those who applied on HealthCare.gov, which now handles the exchange for 37 states that didn’t set up an exchange on their own.
Health care experts empathize with the government entities’ tasks.
“The Affordable Care Act overall and the health insurance exchanges in particular are extraordinarily difficult to estimate,” said Kip Piper, a former Wisconsin and HHS official. “Nothing of this magnitude or complexity has ever been attempted.”
CBO’s projections were “reasonable guesses but within wide ranges,” Piper said.
“The ACA resulted in some Americans gaining coverage, others losing it, and many more moving from one kind of coverage to another,” Piper said. “It will take several years before the musical chairs stops and we can parse the data to understand what happened, when, and to whom.”
Source: USA Today
http://www.usatoday.com/story/news/nation/2014/11/10/obamacare-enrollment-numbers-cbo-projections/18798095/