Obama administration lowers bar for 2016 open enrollment
HHS is predicting only a small increase in the number of people signing up for insurance through Affordable Care Act exchanges for 2016.
The estimate of 10 million enrolled by the end of the third open-enrollment period is less than half of what the Congressional Budget Office had projected would be covered for the year.
HHS Secretary Sylvia Mathews Burwell called the department’s estimate a “strong and reasonable goal” for the enrollment period that runs Nov. 1 to Jan. 31. It is a modest increase from the 9.1 million expected to have coverage at the end of this year. Richard Frank, assistant secretary for planning and evaluation at HHS, said during a conference call with reporters Thursday that the CBO projection of 21 million enrollees in 2016 assumed significantly larger numbers of people switching from employer-sponsored plans to the exchanges than has occurred.
The 2016 goal of 10 million includes mostly those who are expected to reenroll in marketplace plans from 2015. About 1 million now in the non-exchange individual market are projected to switch to the exchange. The rest would be previously uninsured Americans who qualify for exchange coverage.
The total number of the eligible uninsured is about 10.5 million. The 2016 goal calls for signing up about 25% of them.
Burwell said about 80% of that 10.5 million would be eligible for financial assistance, but most don’t know that or misunderstand how assistance works.
CMS spokeswoman Lori Lodes said the department understands that the remaining uninsured will be more difficult to reach and is developing directed advertising and education to try to get them to sign up.
The penalty for not having insurance in 2016 jumps to $695 per person or 2.5% of household income, whichever is higher. For 2015, the penalty was $325 or 2% of household income.