Health care plan enrollment gears up for year two

05/02/2014 3:32 PM

05/02/2014 9:01 PM

The push to sign up people for Obamacare won’t get any easier in year two.

The Obama administration needs to improve everything from customer service to Spanish language outreach if it is to parlay a functioning website and recent enrollment momentum into even more Americans with health coverage, supporters say.

In addition, data released Thursday showed that fewer-than-expected young and generally healthy people in the 18-to-34 group signed up for coverage. About 28 percent of the people picking plans on the state and federal insurance exchange were young, but that’s significantly below the 40 percent mark some analysts consider important for holding down rates.

“Adding new people — the marginal enrollment — only gets harder and harder,” said George Brandes, director of health care programs at tax preparer Jackson Hewitt. “For whatever reason, these people sat on the fence. This is no longer the low-hanging fruit.”

Eight million people signed up for private plans under the Patient Protection and Affordable Care Act through April 19, the government reported Thursday. The total includes a surge of 910,000 enrollments in the past month highlighted by young, low-income applicants.

The Congressional Budget Office expects an average of 13 million people to enroll in private health insurance plans for 2015 using the marketplaces created under the law commonly known as Obamacare. Enrollment surpassed expectations this year, and next year a penalty on people who don’t carry insurance will double to as much as 2 percent of income. The federal website that is expected to serve 35 states next year,, no longer suffers regular malfunctions.

There remains an ample market of uninsured Americans. About 48 million people lacked coverage in 2012, according to the Census Bureau, and indications are that few of them signed up this year. About 5.5 million people who filed applications for insurance through government exchanges and were told they were eligible to buy a plan never finished the process, according to the federal data.

“I don’t think we really have the answer for that right now,” Mike Hash, director of the Office of Health Reform at the Department of Health and Human Services, said when asked why those applicants didn’t sign up for coverage.

The administration faces challenges to reach those potential customers, supporters of the health care law said. The enrollment period for 2015 begins Nov. 15 and is just three months, half as long as this year. The federal government may not have as much money to spend on advertising or on groups that help people sign up. Negative ads and speeches about the law from Republicans leading up to Nov. 4 congressional elections may confuse uninsured Americans, deterring enrollment.

The law’s supporters say the Obama administration can take steps unilaterally, without the help of Congress, to boost participation.

The Spanish language health exchange websites still lag behind English versions. Better coordination of enrollment with tax season may raise awareness about the penalties for not carrying coverage. Customer service representatives at call centers should be trained to better respond to off-script questions, said Tricia Brooks, a researcher at the Georgetown University Center for Children and Families.

“To get to 13 million, we want to make sure we don’t slide backward at all,” she said.


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