Health Care

Obamacare Reaches Critical Enrollment Deadline

Want coverage on Jan. 1? Today is your last chance to get it.

This December 2, 2013 photo shows a woman reading the insurance marketplace internet site in Washington, D.C.
National Journal
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Sam Baker
Dec. 23, 2013, midnight

Monday is a big day for Obama­care: It’s the dead­line to sign up for health in­sur­ance that be­gins Jan. 1.

There are still an­oth­er three months to buy cov­er­age, but a lot of people need it on Jan. 1. It’s an im­port­ant dead­line for people with preex­ist­ing con­di­tions who had been priced out or overtly locked out of the in­di­vidu­al in­sur­ance mar­ket and are now eager to get covered. And it’s an im­port­ant dead­line for the mil­lions of people whose in­sur­ance policies were can­celed be­cause of the Af­ford­able Care Act.

Both groups were largely un­able to shop for new plans in Oc­to­ber and most of Novem­ber, when Health­ was mired in tech­no­lo­gic­al prob­lems. The White House has re­por­ted an en­roll­ment surge in Decem­ber, ahead of the dead­line to sign up in time for Jan. 1 — the earli­est pos­sible start date for plans sold through the law’s in­sur­ance ex­changes.

Crit­ics have raised the pos­sib­il­ity that be­cause of plan can­cel­la­tions and the broken web­site, more people will have lost cov­er­age on Jan. 1 than gained it.

That is prob­ably un­know­able — one has a re­li­able es­tim­ate of how many plans were can­celed. The White House says only about 500,000 people had their plans can­celed and are now without cov­er­age, while Re­pub­lic­ans have put the total num­ber of plan can­cel­la­tions well in­to the mil­lions.

The end of Decem­ber also marks the halfway point in the six-month win­dow to sign up for cov­er­age through the ex­changes. Giv­en the web­site’s dis­astrous launch, the ad­min­is­tra­tion will surely fall well short of its pre-launch ex­pect­a­tions. The Health and Hu­man Ser­vices De­part­ment had es­tim­ated that 3.3 mil­lion people would sign up for private in­sur­ance by the end of the year. It was 3 mil­lion people short of that mark at the end of Novem­ber.

We won’t know un­til Janu­ary how many people signed up in Decem­ber. It prob­ably won’t be 3 mil­lion, but ad­min­is­tra­tion of­fi­cials say they’ve seen a surge with the web­site re­paired and the Dec. 23 dead­line loom­ing. The first two days of Decem­ber alone saw roughly 29,000 en­roll­ments — more than in the en­tire month of Oc­to­ber.

HHS has beefed up ca­pa­city over the past few weeks to handle the an­ti­cip­ated last-minute rush. Ad­min­is­tra­tion of­fi­cials said they have ad­ded roughly 800 new rep­res­ent­at­ives to Obama­care’s call cen­ters, bring­ing them up to about 12,000 trained agents. Health­, the en­roll­ment portal serving 36 states, has been mostly stable since Dec. 1, when the ad­min­is­tra­tion de­clared suc­cess in its push to have the site work­ing “for the vast ma­jor­ity of users.”

Ad­min­is­tra­tion of­fi­cials said they might have to de­ploy the web­site’s new queuing fea­ture today, if the num­ber of people try­ing to beat the dead­line is more than the site can handle at one time. The sys­tem al­lows users to enter their e-mail ad­dresses and no­ti­fies them when traffic sub­sidies.

In a brief­ing with re­port­ers last week, ad­min­is­tra­tion of­fi­cials said it was pos­sible that users who tried to sign up today would be queued un­til to­mor­row — mean­ing they would tech­nic­ally miss the Dec. 23 dead­line. The of­fi­cials said they were work­ing on a plan to en­sure that those people would still have their cov­er­age be­gin on Jan. 1, since it wouldn’t be their fault they missed the dead­line.

The Dec. 23 cutoff leaves in­sur­ance com­pan­ies with little time to pro­cess en­roll­ments, and things will un­doubtedly be messy as people try to use their new cov­er­age.

Prob­lems with Health­‘s trans­mis­sions to in­sur­ance com­pan­ies could res­ult in people not hav­ing the cov­er­age they thought they had pur­chased. And con­sumers tech­nic­ally aren’t en­rolled un­til they pay their first month’s premi­um. At the ad­min­is­tra­tion’s ur­ging, in­surers have agreed to give con­sumers un­til Jan. 10 to make that pay­ment and still have their cov­er­age be­gin, ret­ro­act­ively, on Jan. 1.

A seni­or ad­min­is­tra­tion of­fi­cial noted last week that con­fu­sion about in­sur­ance cov­er­age ex­is­ted be­fore Obama­care; people some­times have to call and ar­gue with their in­sur­ance com­pany when they try to fill a cer­tain pre­scrip­tion, for ex­ample. Still, the of­fi­cial said, HHS will be mon­it­or­ing those is­sues as cov­er­age kicks in and will at­tempt to re­spond quickly to gaps caused by the en­roll­ment pro­cess.


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