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Health Care Reform:

Health Insurance & Affordable Care Act

Will Low Online Enrollments In The Fall Hobble The Health Law?

WebMD News from Kaiser Health News

By Jay Hancock

Thu, Nov 14 2013

By Phil Galewitz

Hope that the health law’s online insurance marketplaces will work well enough to enroll millions this fall had already faded before the administration disclosed results Wednesday. News that only 27,000 had signed up for private coverage on the federally run marketplaces through October amplified the doubts.

Experts increasingly doubt the federal site serving 36 states will function properly by the White House’s self-imposed Nov. 30 deadline -- or maybe even by Jan. 1, when insurance coverage is scheduled to begin. Some state-built sites, which enrolled 79,000 in October, have their own problems.

Web portals selling insurance directly to Americans lacking affordable, comprehensive coverage are the heart of the Affordable Care Act.

How much does their early failure jeopardize President Barack Obama’s marquee law? Are functioning insurance portals essential to other goals of the law? Kaiser Health News asked analysts for a damage report.

Q: Can the federal portal be fixed in time?

A: Many don’t think so, and some worry about the consequences.

“Given where they are right now, it would be an unbelievable feat if they were to be ready” even by Jan. 1, said Bill Copeland, a top health care consultant at Deloitte.

The administration faces a credibility problem if it fails to meet the Nov. 30 deadline, said Dr. Ezekiel Emanuel, a former White House health care adviser. Signup delays could distract consumers from the benefits of coverage and cause many to tune out, he said.

Q: Why not wait until the websites are fixed and then have people line up? Or extend the enrollment period for individuals to gain coverage into the middle of next year?

A: Many can’t wait. Their policies expire Dec. 31, and they fear a gap in coverage. Others are uninsured and had expected ACA benefits starting in 2014.

Waiting worries insurers, too. They designed and priced marketplace policies based on the idea that consumers would enroll between Oct. 1 and March 31 for coverage starting as early as Jan. 1. Delaying signup could leave carriers with disproportionately sicker and more expensive customers, they say.

Q: What about a bigger fix? Let people keep the policies they have for another year. Or create a bailout pool for those who need emergency coverage until the websites presumably work in 2015.

It’s getting late even for extending this year’s policies. In many cases neither insurers nor state regulators are prepared.

“If we had known this was going to happen in September, early renewing (of existing plans) probably was going to be the answer,” said Joseph Antos, a health economist at the American Enterprise Institute. “Now that we know in November it’s not looking too great.”

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