With the Affordable Care Act's (ACA's) third Open Enrollment Period well underway, recent reports suggest another successful sign-up period. As of Nov. 25, the OEP's third week, an estimated 1.6 million Americans have enrolled coverage through HealthCare.gov. And more promising news is that about one-third (500,000) of these enrollees were new customers. These results are an indication that the 2016 plan year should continue the positive results for the healthcare law.
Running from Nov. 1, 2015, through Jan. 31, 2016, this OEP should see an expected 10 million customers enroll in ACA-compliant plans by the end of 2016. 10 million is the number calculated by the Congressional Budget Office (CBO), the federal agency responsible for healthcare spending and related policies.
Impressive tallies seen so far
In total, the first week of open enrollment saw more than 540,000 consumers selecting policies. About 358,000 were existing customers reenrolling. And a little more than 1.15 million customers submitted applications through HealthCare.gov. It's likely that they were trying to qualify for cost-saving measures, such as Advanced Premium Tax Credits (APTCs) and cost-sharing reductions.
The 540,000 enrollees is very impressive, as Nov. 15-Nov. 21, 2014, the OEP's first week, saw only
462,125 plan selections and 1.03 million applications submitted. Compared to 2014, the 2015 OEP's first week plan selections and application submissions increased by about 17 percent and 12 percent, respectively.
One requirement of the ACA is that for policies to begin on Jan. 1, 2016, customers must enroll by Dec. 15, 2015. However, the 2015 calendar year actually has 15 additional days to enroll than in 2014. But while it was thought that this would lead to lower initial enrollment numbers, this hasn't been the case.
The part penalties and premiums play
However, certain issues may impact enrollment as the OEP continues. First, for the second year in a row, the ACA's tax penalties for not purchasing health insurance will be increasing. In 2015, the penalty equaled the greater of $325 or 2 percent of an individual's modified adjusted gross income (MAGI). But in 2016, this increases to the greater of $695 or 2.5 percent of an individual's MAGI.
Second, there is the issue of increased premium prices. This is due to such factors as rising prescription drug costs and higher medical utilization rates, as sicker individuals are among the first to sign up for coverage. Even though they're consistent with average inflation rates, the 2016 premiums represent the highest increase this decade.
As such, some customers, new and existing, may be wary to enroll in plans.
But the HHS, the agency tasked with overseeing the ACA, has taken great strides to ensure this year's enrollment goes smoothly. For instance, there is a new feature for HealthCare.gov, enabling consumers to search health plans by preferred doctors or facilities. The HHS also provided a search tool showing estimates for total out-of-pocket costs, including deductibles, copays and coinsurance.
The bottom line is that these enrollment statistics are crucial to the federal government and the American healthcare system. They illustrate whether the ACA is doing well or not. "It's a solid start and I'm pleased with the consumer engagement we've seen over this last week," stated Sylvia Mathews Burwell, the Secretary for the Department of Health and Human Services (HHS). "Our partners were ready to work, and people were ready to sign up."