The Obama administration expects fewer than 10 million people to enroll in marketplace health coverage next year, far below the 13 million people that the Congressional Budget Office has projected.
The 2015 enrollment season for marketplace health insurance begins Saturday, and consumers can expect more coverage choices, a better functioning network and an easier enrollment process for most new first-time users, according to the Obama administration.
After last year’s disastrous rollout of the HealthCare.gov website, the U.S. Department of Health and Human Services spent the past year upgrading, simplifying and fully testing the glitch-prone process that serves 36 states. Officials expect the redesigned and more muscular system to handle more than 125,000 concurrent users.
The CBO projected marketplace enrollment to reach 13 million in 2015, 24 million in 2016 and a “steady rate” of 25 million in 2017 as the program is fully implemented.
That aggressive growth assumed a significant decline over the next two years in both employer-based insurance and non-marketplace individual coverage. But a new HHS analysis suggests the CBO projections may be unrealistic.
Senior administration officials say there’s “mixed evidence” and “considerable uncertainty” about the CBO’s expectation of a large two-year movement away from job-based coverage and individual coverage purchased outside the marketplace.
Those uncertainties and the history of slower enrollment growth in programs like Medicaid and the Children’s Health Insurance Program suggest it could take four to five years – until 2019 –for the state and federal marketplaces “ramp up” to 25 million enrollees.
As a result, the Obama administration expects only 9 million to 9.9 million people to enroll in marketplace coverage by the end of 2015. This year’s enrollment period, which begins Nov. 15, will run for just three months, through Feb. 15, instead of six months like last year.
Officials are promising an improved user experience when open enrollment begins, with a streamlined application process that will allow 70 percent of first-time HealthCare.gov enrollees to complete their coverage applications by navigating through just 16 computer screens, instead of 76.
The remaining 30 percent whose household characteristics are more complex will use the traditional application process.
Consumers returning to HealthCare.gov already have received notices in the mail and in their HealthCare.gov accounts explaining the re-enrollment process. When they begin, 90 percent of their online application already will be filled out.
To ensure new coverage is effective on Jan. 1, 2015, applicants must complete the enrollment process no later than Dec. 15.
People who don’t re-enroll for 2015 will be auto-enrolled in the same plan with the same premium tax credits as last year. Those who want to change plans must do so by Feb. 15. For those that do, their new plan coverage will begin on the first day of the next month or, depending on when they enroll, the second month.
The HealthCare.gov website also has been optimized for mobile usage, so people with smartphones or tablets can better navigate the site and shop for coverage.
Users will find some of the most frustrating aspects of the online application process have been eliminated. The new system allows users to browse and compare health plans without creating a user account. And a backward navigation function lets applicants correct information on previous screens without having to start all over.
Shoppers on HealthCare.gov will find 57 more insurers – 248 compared with 191 last year.
That’s a 30 percent increase over 2014. Among states using the federal marketplace, Texas, Michigan and Ohio are projected to have the most insurers, with 16. Pennsylvania and Wisconsin are next with 15, followed by Florida with 14.
As of Oct. 20, Colorado, Maryland, New York, Ohio, Oregon, Rhode Island, Vermont and the District of Columbia had approved rates for individual coverage purchased both on and off the state and federal marketplaces, according PricewaterhouseCoopers’ Health Research Institute.
In those states, premiums have increased by an average of just 3.5 percent from 2014, while the average 2015 premium is $344, PricewaterhouseCoopers found. The average premium increase across all 41 reporting states was 6 percent and the average premium was $381.
As of mid-October, 7.1 million people were enrolled in marketplace health plans, down from 7.3 million in September. About 110,000 people lost coverage for not providing the proper information about their income or citizenship and immigration status, officials said.
The administration expects 83 percent of the 7.1 million plan members – 5.3 million – to renew their coverage. Many of the 1.8 million others are expected to move to job-based coverage or Medicaid.
The number of uninsured working-age adults has fallen by 10.3 million, or 26 percent since 2013, due mainly to the Affordable Care Act’s coverage mandates and Medicaid expansion. Of the estimated 32 million remaining uninsured Americans, roughly 17 million are thought to be eligible for Medicaid, leaving an estimated 15 million who could purchase marketplace coverage.
Another 8 million to 12 million have individual coverage purchased outside the marketplace. Many of them also could become marketplace buyers in 2015. HHS expects 75 percent to 80 percent of new marketplace enrollees in 2015 to be previously uninsured.