ACA enrollment estimates dip before exchanges open

The number of people signing up for insurance through the federal and state healthcare exchanges during the second enrollment period beginning on November 15 could be fewer than originally projected, according to Secretary of the U.S. Department of Health and Human Services (HHS) Sylvia Mathews Burwell.

A total of 9.1 million people could sign up for healthcare insurance in the second enrollment, according to Burwell, who made her prediction during a Center for American Progress event on November 10. “We are moving to a group that might be harder to reach,” Burwell said.

Projections for new enrollees during the second open enrollment period for the exchanges have varied between government agencies. In a report released by HHS on November 10, the Congressional Budget Office (CBO) estimates that 13 million will enroll between November 15 and the end of the second enrollment period on February 15, 2015. HHS estimates that between 10 million and 11 million people would gain insurance during the upcoming enrollment period. By 2017, CBO estimates 25 million people will have obtained insurance through the exchanges.

The HHS report also says that it will take time for the enrollment on the exchanges to “‘ramp up’ to its long run ‘steady state’ level. While there is broad agreement that the number of people without health insurance will continue to fall in the coming years, projections differ in how quickly those reductions will occur and where individuals will obtain coverage. Moreover, in the early years of any new program, there is a high degree of uncertainty about projections; actual enrollment could be significantly higher or lower.”

Media reports suggest that the Obama administration may be struggling to attract new enrollees to the exchanges. The Healthcare.gov website is open for “window shoppers” this week for potential enrollees to preview available plans. “Because the analysis anticipates that 5.9 million customers will renew coverage and that up to 9.9 million will be covered by the end of 2015, that means the administration is expecting no more than 4 million first-time customers during this second enrollment period - half as many as last time,” the Washington Post reported.

In April, the Obama administration reported that 8 million people signed up for healthcare insurance during the first enrollment period. According to HHS’ reported adjusted enrollee figures, however, 7.1 million bought healthcare insurance in the first enrollment period between October 2013 and March 2014. The lower number was due to people who either didn’t pay their premiums or were not eligible for insurance due to problems with citizenship.