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Obamacare Enrollment Will Barely Increase Next Year, Feds Say

The Huffington Post The Huffington Post 15/10/2015 Jeffrey Young

WASHINGTON -- Fewer than 1 million new customers nationwide will have health insurance from the Obamacare exchanges next year, according to a federal report published Thursday.

The Department of Health and Human Services estimates that 10 million people will be covered by private health insurance policies obtained via the Affordable Care Act's exchange marketplaces in 2016, an increase of just 900,000 from the 9.1 million people the department estimates will have such plans by the end of this year.

This nearly flat estimate of growth on the exchanges reflects both the successes so far and the challenges ahead for the the new marketplaces created by the Affordable Care Act. The nationwide uninsured rate has plummeted since 2013 as an estimated 15 million people gained coverage from the exchanges or the law's expansion of Medicaid eligibility. But Health and Human Services Secretary Sylvia Burwell acknowledged last month that those uninsured most eager to enroll have already done so, and that the remaining millions would be difficult to reach .

“We believe 10 million is a strong and realistic goal,” Burwell said in conference call with reporters Thursday. “We’ve seen high levels of satisfaction with the marketplace and expect the vast majority of folks will re-enroll. And our target assumes something that is probably pretty challenging, which is that more than one out of every four of the eligible uninsured will select plans,” she said.

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Attrition on the health insurance exchange has been a factor. After the the 2015 sign-up period that ended in February, 11.7 million people had selected insurance plans from the marketplaces. That number declined throughout the course of the year, as consumers either failed to pay premiums or dropped coverage for reasons including affordability concerns and switching to health benefits provided by an employer. Nearly 1 million people  dropped off the exchange because they failed to provide accurate documentation of their incomes to prove they qualified for subsidies, and more than 400,000 others lost their coverage because they did not verify they were legal U.S. residents. 

During the enrollment period for 2016 coverage that begins Nov. 1 and ends Jan. 31, HHS expects that as many as 8.8 million current enrollees will use the exchanges to obtain coverage for next year, up to 3.9 million currently uninsured will sign up and as many as 1.5 million people who today have plans purchased directly from an insurer will switch to the marketplaces, according to Thursday's report.

Federal authorities expect a similar pattern of enrollment and disenrollment during the upcoming sign-up period as they experienced in 2014 and 2015. Although HHS estimates between 11 million and 14.1 million people will use the exchanges to get health insurance for 2016, millions will go off those plans during the course of the year, the department projects.

While the health insurance exchanges have made significant strides since their rocky rollout two years ago, new challenges await during the upcoming sign-up period.

Premiums for coverage that begins next year appear to be rising faster than they did prior to the last round of enrollment. Other indicators suggest that the prices for the "benchmark" plans used to set the value of premium subsidies aren't going up as much , but consumers will have to shop around if they hope to find coverage at a cost comparable to what they're paying now. In a number of states, enrollees will be forced to find new plans because of the financial collapse of nonprofit "co-op" insurance companies funded by the Affordable Care Act.

One factor that could boost enrollment -- at the risk of public backlash -- is heftier fines for those who go without health insurance but aren't  exempt from the law's individual mandate . The minimum penalty for the 2015 tax year is $325 per adult and $162.50 per child or 2 percent of household income above about $10,000, whichever is higher. That fine gets much bigger for 2016 : $695 per adult plus $347.50 per child, or 2.5 percent of income above $10,000. This year, 6.6 million people paid this fine for being uninsured in 2014 and the average amount was $190, according to the Internal Revenue Service.

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