Oba­macare en­rollees must dou­ble to hit CBO tar­get

The Washington Times Weekly - - National - BY TOM HOW­ELL JR.

Pres­i­dent Obama will need to more than dou­ble the num­ber of Amer­i­cans en­rolled in Oba­macare ex­change plans to reach 21 mil­lion next year, the tar­get set in bud­get pro­jec­tions, in what is shap­ing up as the next ma­jor test for the health care law.

As of June, the Depart­ment of Health and Hu­man Ser­vices counted 9.9 mil­lion cus­tomers who have bought plans through the fed­eral HealthCare.gov por­tal and a hand­ful of state-run ex­changes.

That puts the ad­min­is­tra­tion ahead of its own es­ti­mates for 2015, but is less than half what the Con­gres­sional Bud­get Of­fice pro­jected for 2016, show­ing just how much work of­fi­cials have ahead of them as the next round of en­roll­ment be­gins in less than two months.

In­dus­try an­a­lysts said the CBO’s es­ti­mate for next year is “overly op­ti­mistic” and a “stretch,” and that it will take more time for the law to at­tract that many peo­ple onto the Web-based mar­kets, where con­sumers shop for pri­vate health care plans and typ­i­cally qual­ify for gov­ern­ment sub­si­dies to re­duce their monthly premi­ums.

“Given where things stand, the ramp-up of en­roll­ment may be slower than ini­tially an­tic­i­pated,” said El­iz­a­beth Car­pen­ter, a vice pres­i­dent at Avalere Health, a D.C.-based con­sul­tancy.

Open en­roll­ment for the third go-around of Oba­macare’s ex­changes be­gins Nov. 1, and the ad­min­is­tra­tion is count­ing on win­ning over mil­lions of cus­tomers who didn’t sign up the first two years but who could be pres­sured by the in­creas­ing pain of the “in­di­vid­ual man­date” tax as­sessed on those who forgo health in­sur­ance.

“It is def­i­nitely some­thing that peo­ple pay at­ten­tion to,” said Rachel Klein, di­rec­tor of or­ga­ni­za­tional strat­egy at Fam­i­lies USA, a non­profit that ad­vo­cates for af­ford­able health care.

The tax dur­ing the first year was $95 or 1 per­cent of in­come above the fil­ing thresh­old — a rel­a­tively mi­nor bite. This year, the penalty will be $325 or 2 per­cent of in­come, and by 2016 it will be $695 or 2.5 per­cent of in­come.

“The sub­stan­tial in­crease in penal­ties un­der the in­di­vid­ual man­date next year is a big wild card,” said Larry Le­vitt, a se­nior vice pres­i­dent at the Kaiser Fam­ily Foun­da­tion, a non­par­ti­san health pol­icy or­ga­ni­za­tion. “We’re in un­char­tered ter­ri­tory here about how ef­fec­tive these big­ger penal­ties will be in nudg­ing peo­ple to get in­sured.”

“The mar­ket­places are work­ing,” Mr. Le­vitt added, “but higher en­roll­ment would both im­prove the in­sur­ance risk pool and re­duce the num­ber of Amer­i­cans unin­sured.”

The in­di­vid­ual man­date was in­cluded in the Af­ford­able Care Act of 2010 to make sure enough healthy Amer­i­cans signed up, spread­ing out the costs for higher-risk cus­tomers.

A di­vided U.S. Supreme Court up­held the man­date in 2012 as an ap­pro­pri­ate use of Congress’ tax­ing power.

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