10 million – not 20 million – should have Obamacare plans by 2017

In advance of the November 1 opening of the third annual open enrollment period for health insurance under the Affordable Care Act, the Obama administration is targeting 10.5 million uninsured Americans who qualify for health care coverage through the marketplaces the law created.

Meanwhile, the administration has noted it could be hard to reach those who remain uninsured, as those who were already inclined to enroll in exchange coverage or were easiest to reach have already signed up for exchange plans. About 2.8 to 3.9 million of the roughly 10.5 million eligible uninsured will select plans during open enrollment, Burwell said. According to the reports, almost 8 in 10 of the approximately 10.5 million uninsured individuals likely to be eligible for qualified health plans (or the “QHP-eligible uninsured”) may be eligible for financial help through the Marketplaces. That’s less than half of the 29 million that the nonpartisan Congressional Budget Office (CBO) projected for next year. A few of the ones that follow through joining the exchanges later find a job with cheaper premiums and drop out, and other still just stop because they cannot afford even the subsidized premiums.

Last year, 85 percent of marketplace consumers received an average tax credit of around $270 per month, according to the HHS.

Enrollment United States of America allows users to verify that their health plan is the most affordable, based on specific factors like prescription drugs, how much they are willing to pay out of pocket and how they prefer to pay for insurance. “About half have less than $100 in savings”. And almost 970,000 households had their subsidies “adjusted” because of problems documenting their incomes.

As noted, the enrollment decline in employer-sponsored coverage offset nearly all (94 percent) of the net gain in individual-market coverage for the year.

While it is not possible to determine from the data the subsequent coverage status of individuals who lost group coverage, there are four possibilities: (1) some obtained replacement individual-market coverage (either on or off the exchanges); (2) some enrolled in Medicaid; (3) some enrolled in other coverage for which they are eligible (such as a plan offered by their new employer, a spouse’s plan, a parent’s policy, or Medicare); and (4) some became uninsured. The insurer recently announced it would cancel its Preferred Provider Organization (PPO) health plan on the exchange – affecting roughly 370,000 Texans. “This is why the financial incentives and other provisions of the law are so important”.

“Underlying this projection is the reality that the remaining uninsured are getting harder to reach, so it’s going to very tough to increase enrollment substantially”, Levitt said. Similarly, your coinsurance costs – the percentage you’re responsible for once your deductible has been met – may be higher with a low-end plan.

In addition, officials say the ACA’s individual mandate penalties could play a larger role during the upcoming open enrollment period (Pradhan, Politico, 10/15).