The Obama administration has its message ready for when the Obamacare marketplaces open on Sunday: most shoppers can find the help they need to enroll in plans they can afford.
The third year of enrollment under the 2010 Affordable Care Act promises to be both the easiest and the hardest yet for the administration. The federal marketplace, healthcare.gov, has undergone improvements for several years now, promising consumers a better experience than during the initial, glitchy months.
Yet Health and Human Services Secretary Sylvia Mathews Burwell, leader of the agency spearheading the effort, readily admits that the remaining uninsured people are the hardest population still to reach.
“We’re in a place where we know it’s going to be harder, but we need to work smarter,” Burwell told reporters Thursday.
Most of the 32 million Americans still lacking health coverage are low-income. To reach them, the agency is highlighting that most will qualify for a federal subsidy to make plans cheaper. The agency also is emphasizing new tools on healthcare.gov allowing them to see whether a particular plan would still allow them to see their current doctor or cover their prescription drug.
“What we’re trying to do is make sure we do everything possible to make it easier on the consumer,” Burwell said.
Burwell has set a modest enrollment goal for the upcoming enrollment season, saying she expects only slightly more people to sign up than last year. In June, 9.9 million Americans had paid for coverage. During this season, the administration is aiming for 10 million enrollees.
Additionally, the administration hopes to reach one in four of those who qualify to buy plans on the exchanges but haven’t purchased any. Those include people who don’t have employer-sponsored coverage and aren’t eligible for Medicaid.
Because some people won’t ever pay their first month’s premium or will drop out during the year, the final number of enrollees will be less than those who initially select a plan, officials say.
It’s not clear whether enough people will gain coverage next year to meet recent projections by the Congressional Budget Office, which estimated that the number of uninsured will drop to 29 million in 2016. Enrollment begins Sunday and lasts through January.
Burwell said she has spent the last few days traveling to West Virginia and Texas, two states that have experienced vastly different outcomes from the healthcare law. While Texas has rejected the law’s Medicaid expansion, leaving many of its low-income residents without access to affordable coverage, West Virginia has embraced expansion and seen its uninsured rate fall dramatically.
There’s also major variation among the states when it comes to changes in the monthly premium consumers must pay. In a small handful of states, including Indiana and Mississippi, the average price for a mid-level “silver” plan is falling. But in the rest it’s rising, including some large increases over 30 percent in Alaska, Montana and Oklahoma.
Asked about the premium increases, Burwell acknowledged there are “places where we want to encourage competition and encourage people to come into the marketplace.”
But she emphasized that it’s important to remember that about eight in 10 shoppers have incomes low enough to qualify them for subsidies. “It’s important to talk about the premiums in the context of financial assistance,” she said.
In anticipation of the enrollment launch, HHS is still running drills on healthcare.gov although most of the technological testing has been done, Burwell said. She wouldn’t say whether the new tools for shoppers will be available immediately, saying the agency needs to collect enough information about provider and drug coverage to ensure they’re useful.
The agency also has streamlined several other parts of healthcare.gov, reducing the amount of data people must enter manually and making it easier for them to quickly view whether they’re eligible to buy a plan and collect subsidies for it. The website also will include an out-of-pocket cost estimator to help them select the plan that best fits their medical needs.
“You’ll hear us talking about how it’s easier to sign up,” Burwell said. “Whether that’s the technology or operations or whatever we’re doing.”
? This article was originally published at 2:23 p.m. and has been updated.
