8 million enrollment total tops good-news week for Obamacare
Higher-than-expected enrollment, lower-than-expected premiums and subsidy costs, and increased interest from insurers made last week a good one for Obamacare, leaving Republican critics scrambling to figure out how to respond.
President Barack Obama announced on Thursday that 8 million Americans had signed up for private health plans on the federal and state insurance exchanges by the end of extended open enrollment April 15. “This thing is working,” Obama said at the White House. “We now know for a fact that repealing the Affordable Care Act would increase the deficit, raise premiums for millions of Americans and take insurance away from millions more.”
In addition, the Congressional Budget Office last week lowered its 10-year cost estimate for the Patient Protection and Affordable Care Act by more than $100 billion. The main reason is it expects premiums to be 15% lower in 2016 than previously projected, meaning the government will spend less on premium subsidies. The CBO said the lower premiums result from insurers offering exchange plans with narrower provider networks and more restrictions on care than are typical of the employer-based market.
The CBO also estimated that 5 million Americans signed up for individualmarket insurance for 2014 outside the Obamacare exchanges.
In other good news for Obama, research by the Society of Actuaries suggested that 2015 premiums for exchange plans will likely increase by 6% to 8.5%, well below the double-digit hikes some experts have warned about and more in line with rate increases in recent years.
There’s also mounting evidence that insurers are becoming more bullish on the exchange markets. Two of the largest publicly traded insurers— unitedhealth Group and Cigna Corp.— indicated that they expect to compete more aggressively in the exchanges in 2015 after taking a conservative approach this year. “We do have a bias to increase that participation in 2015,” Gail Boudreaux, executive vice president of United Health Group, said during a call
We now know for a fact that repealing the Affordable Care Act would increase the deficit, raise premiums for millions of Americans and take insurance way from millions more.”
—President Barack Obama
with investors Thursday.
The 8 million sign-up figure exceeded even the most optimistic projections. “It’s a huge number, especially after that really rocky, disastrous rollout,” said Sabrina Corlette, a professor at Georgetown University’s Center on Health Insurance Reforms. “It’s just indicative of the need that’s out there.”
Congressional Republicans challenged the figure, saying it’s still unknown how many of those people will complete the enrollment process by paying their first premium. They also criticized the upheaval that the law has caused in the market. They have continued calling for repeal of the ACA.
“Countless Americans have unexpectedly been forced out of the plans they had and liked, are now shouldering dramatically higher premiums, and can no longer use the doctors and hospitals they choose,” Senate Minority Leader Mitch McConnell (RKy.) said in a written statement.
Beyond the final sign-up total, insurers liked that enrollees skewed younger during the final weeks of enrollment, with 28% of those signing up for exchange plans ages 18 to 34. That was up from 25% at the end of February. Though it’s still below the 35% to 40% that experts say is ideal for a balanced risk pool, some insurers have indicated it’s about what they expected and they set their 2014 premiums accordingly.
Insurers and officials in at least 10 states, including California and Michigan, said they expect at least one more competitor in their exchange marketplaces for 2015.
The Obama administration has not released data on how many of the new enrollees were previously uninsured. In addition, there’s no way to know how many people will continue paying their premiums throughout the year, though many in the individual market traditionally come and go as they lose and gain jobbased coverage.
The administration still hasn’t finished building the back-end system needed to verify enrollment data and make sure insurers get accurate payments. Without that, it’s hard for the administration to back up its enrollment figures, said Stephen Parente, a healthcare policy expert at the University of Minnesota who advised Sen. John McCain’s 2008 presidential campaign.
Still, some observers say Obamacare’s enrollment turnaround after the botched rollout last fall puts Democrats in a stronger position for the November congressional elections. “Republicans are probably putting too many eggs in the healthcare repeal basket,” said Jacob Hacker, a political science professor at Yale University. “The ship is launched, and it’s actually floating. That changes the politics a lot.”