A surge of signups is expected this week as Obamacare’s open enrollment heads toward its Friday deadline, which is likely to cause the website glitches and call center backups that customers have endured in past years.
It’s not clear how large the surge will be. According to the federal data, signups reached 3.6 million people on Wednesday. While the number is bigger than signups at the same time last year, the pace will need to increase in the remaining days to match the previous open enrollment signup total of 12.2 million people.
Because people tend to procrastinate, a wave of signups typically occurs during open enrollment’s closing days. The Obama administration said its research showed that these customers tend to be younger and healthier.
“In the last week before the deadline every year since we have had open enrollment, people tend to wait until just before the deadline,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, speaking at a Facebook live event to help consumers. “Like any other website, when it gets busy and a lot of people are trying to hit it at the same time the website can slow down.”
Pollitz said in the past that the site sent customers to a “waiting room” during peak periods, where a screen notifies users that the site is overloaded and allows them to begin perusing health plans as they wait.
“I haven’t actually seen the waiting room this year,” Pollitz said, but added that the site may ask users to leave contact information so they can return to the website when it is moving faster.
Lori Lodes, who ran Obamacare outreach under the Obama administration, said that the website and call center get backed up during the final days. In the past, if people are calling about plans over the phone, an automated message would allow them to leave their information to receive a call back. One million customers did this last year.
“This high consumer demand jeopardizes consumers having a smooth experience,” Lodes said.
The Trump administration has not set a target for how many people it expects to enroll in Obamacare plans. Forecasts by Standard & Poor’s Global Ratings show that 10.6 million to 11.4 million people will sign up for Obamacare plans. Charles Gaba, an independent analyst who supports Obamacare, projects the federal healthcare.gov website will sign up 7.5 million people.
The Dec. 15 deadline of 3 a.m. EST isn’t the same in every state. While healthcare.gov is used by 39 states, others that have their own exchange, such as California and New York, have deadlines at the end of January. The Department of Health and Human Services also created a special enrollment period for Florida, Georgia and Texas because of the hurricanes that hit them.
During the Obama administration, consumers who started their application but didn’t finish it in time because of website issues received a grace period. Kelley Turek, executive director of employer and commercial policy at America’s Health Insurance Plans, said the same should not be assumed this year.
“In the past there have been different decisions made about extensions,” she said during a Facebook Live event Monday. “I would not assume that there would be an extension this year. Let’s look at Dec. 15 as the deadline.”
A representative from the Centers for Medicare and Medicaid Services, which oversees Obamacare, also noted that the website was working well but wouldn’t comment on whether customers would have some wiggle room.
“Consistent with our aim to have a seamless open enrollment experience for consumers this year, the website is performing well and consumers can easily access enrollment tools to compare plans and prices,” the CMS official said in an email. “The deadline for people to shop and pick a plan for the upcoming year is Dec. 15. We continue to encourage people to make plan selections by that deadline so that their coverage can begin on Jan. 1.”
Lodes said she believed that CMS should allow those forms to be completed.
“If the reason someone didn’t enroll is because of issues with handling the demand, then CMS has a responsibility to extend the deadline,” she said, adding that the website appears to be working well.
People who don’t sign up for plans have limited ability to do so outside of open enrollment, but there are some exemptions for customers who move, have a baby, or get a divorce. If Congress repeals the individual mandate as part of the tax bill, people who are uninsured will not be penalized by the government.
The final number of people who enroll also depends on a process called auto-enrollment. People who currently hold plans will be re-enrolled automatically into either the same plan or a similar one if they don’t change or cancel them by Friday. Early numbers suggest that there could be more than 6 million current enrollees who, as of Dec. 2, had not taken any action. Last year, 2.8 million people were automatically enrolled in plans.
Customers who don’t receive subsidies from the federal government and end up auto-enrolling could wind up paying significantly higher premiums. In past years they were able to change their plans in January, but this year they would be locked in.
The issues customers face with Obamacare are partly attributable to political turmoil as well as ongoing troubles the exchanges have faced. President Trump has said he does not support Obamacare and has vowed to dismantle it. Republican congressional leaders hope to have another chance to overhaul the law next year, after failing to do so this year.
The battles on Capitol Hill left some consumers confused about how they would be affected. For instance, Kaiser Family Foundation data show that a third of former Obamacare customers and 15 percent of people who are uninsured knew when open enrollment would start.
The Trump administration also made several changes. Under former President Barack Obama, open enrollment lasted 90 days – even longer during the first couple of years as the website was plagued by technical glitches when it launched. The Obama administration had planned to reduce open enrollment to 45 days by 2018, but the Trump administration moved it up a year.
It also cut funding for advertising and outreach. Though officials cited studies to argue that the programs were ineffective at getting people to sign up for coverage, supporters of Obamacare have accused the administration of “sabotage” and said that one of the main reasons people won’t sign up is because they won’t know enough about it or receive enough help.
“The biggest concern we have is that people don’t understand that there is only one deadline this year,” Lodes said. “For the first time, the one and only deadline is Dec. 15; yet, there has not been a meaningful effort from the administration to make sure people have those facts.”
Emails and phone calls have been sent to customers who begin their applications but do not complete it. Despite outreach changes, a changed marketplace landscape is likely to to lower enrollment. This year, even fewer insurers are selling plans, and insurance companies are limiting their plans by curtailing the number of healthcare providers their customers will be able to see. For many customers who don’t receive subsidies from the federal government, coverage may be more expensive, causing them to see options elsewhere.
