Health Care Signups Exceed Hopes, With 4 Million Newcomers to Federal Marketplace

By Robert Pear, The New York Times

WASHINGTON — About 12.7 million people signed up for health insurance under the Affordable Care Act or had their coverage automatically renewed in the third annual open enrollment season, the Obama administration said Thursday.

Sylvia Mathews Burwell, the secretary of the Department of Health and Human Services, said the signups exceeded her goals and her expectations. “Open enrollment for 2016 is over, and we are happy to report it was a success,” she said.

Most of the plan selections were for people in the 38 states — more than 9.6 million — who used the federal website, HealthCare.gov. The other 3.1 million people were enrolled in states that run their own marketplaces.

Ms. Burwell said she was pleased to see that four million of the people signing up through HealthCare.gov were new to the federal insurance marketplace in 2016. This, she said, shows that “marketplace coverage is a product people want and need.”

The administration predicted in October that 11 million to 14 million people would choose health plans for 2016 by the end of open enrollment. The total reported on Thursday is slightly above the midpoint of that range.

Ms. Burwell said that 28 percent of consumers who signed up through HealthCare.gov were in the 18-to-34 age bracket, about the same proportion as last year. Insurers had been hoping to see an increase because those consumers tend to be relatively healthy, so money from their premiums is available to help insurers pay for the care of people who are less healthy.

The three-month open enrollment period began Nov. 1 and ended on Sunday. People who selected health plans must pay their share of the first month’s premium to activate their coverage. Enrollment tends to decline during the year as some people fail to pay premiums, some qualify for Medicaid or employer-sponsored insurance, and some drop their marketplace coverage for other reasons.

In March 2015, the Obama administration announced that nearly 11.7 million people had selected health plans or had been automatically re-enrolled through the public marketplaces. In September, the administration said, actual enrollment stood at 9.3 million — about 20 percent lower.

Federal officials said there might be a smaller decline this year because the new numbers included some cancellations and were therefore more accurate. Still, officials said, they did not know how many of the people with marketplace coverage this year were previously uninsured.

The administration said that more than 17 million uninsured people had gained coverage under the health law because of the new public marketplaces, the expansion of Medicaid and the opportunity for young adults to stay on their parents’ insurance plans until age 26.

Administration officials carefully track the enrollment numbers, which they regard as a yardstick for the success of the Affordable Care Act.

It is unclear how the enrollment data might affect election-year politics. Republican presidential candidates want to uproot the health care law. In the latest poll by the Kaiser Family Foundation, people reporting unfavorable views of the law outnumbered those with favorable views, 44 percent to 41 percent.

In vetoing a bill to repeal major parts of the health law last month, President Obama cited changes that have occurred in the last five years.

“The nation’s uninsured rate now stands at its lowest level ever, and demand for marketplace coverage during December 2015 was at an all-time high,” Mr. Obama said. “Health care costs are lower than expected when the law was passed, and health care quality is higher, with improvements in patient safety saving an estimated 87,000 lives.”

About seven in 10 consumers who had 2015 coverage through HealthCare.gov returned to the federal marketplace and actively selected plans for 2016, federal officials said. More than half of them switched plans.

Four million people used new search tools on HealthCare.gov to find out if particular doctors or prescription drugs were covered — a “sign of the seriousness and time they put into their decisions,” Ms. Burwell said.

Among states using HealthCare.gov, the federal government reported the largest number of signups in Florida (1.7 million), Texas (1.3 million), North Carolina (613,500) and Georgia (587,850).

California, which has its own marketplace, reported signups of nearly 1.6 million, including 425,000 new customers.

In the last week of open enrollment, nearly 700,000 people signed up or were automatically re-enrolled in coverage through the federal marketplace.

Kevin J. Counihan, the chief executive of the federal marketplace, said he saw a surge in the final week in Miami, Atlanta and Chicago and in Texas cities including Dallas, Fort Worth, Houston, Corpus Christi, Harlingen and Laredo.

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