Monday, November 11, 2013

Obamacare Enrollment Falls Far Short of Target

HealthCare.gov Enrollment Falls Far Short of Target

Federal Website Brings 40,000 to 50,000 Enrollees in Private Plans

By CHRISTOPHER WEAVER, TIMOTHY W. MARTIN and LOUISE RADNOFSKY CONNECT
Updated Nov. 11, 2013 7:55 p.m. ET

Fewer than 50,000 people had successfully navigated the troubled federal health-care website and enrolled in private insurance plans as of last week, two people familiar with the matter said, citing internal government data.

The figure is a fraction of the Obama administration's target of 500,000 enrollees for October. The early tally for the HealthCare.gov site, which launched Oct. 1, worries health insurers that are counting on higher enrollment to make their plans profitable.

Technology problems and design flaws have blocked many users from completing insurance applications or even creating accounts to use the site, which serves consumers in the 36 states where the federal government oversees the new health-insurance exchanges.

Scott Trindl, a 59-year-old early retiree in Waukesha, Wis., said he has made attempts at traversing the website part of his daily routine. "I've been stuck," said Mr. Trindl, who hopes the law opens the door to private coverage he has been unable to obtain due to a heart attack he suffered in 2009.

The administration had estimated that nearly 500,000 people would enroll in October, according to internal memos cited last week by Rep. Dave Camp (R., Mich.). An estimated seven million people nationwide were expected to gain private coverage by the end of March, when the open-enrollment period is set to end.

The federal health official directly responsible for the online marketplace, Marilyn Tavenner, told a congressional panel last week the Department of Health and Human Services would release enrollment figures this week.

The administration thus far has said only that about 700,000 people had completed applications in all 50 states, using both the federal and state-run sites, in an Oct. 24 disclosure. An application is an early step for a consumer to determine pricing and eligibility for policies before enrolling.

Ms. Tavenner, who runs the Centers for Medicare & Medicaid Services, and her boss, HHS Secretary Kathleen Sebelius, both have told Congress that the initial numbers would be low.

So far, private health plans have received enrollment data for 40,000 to 50,000 users of the federal marketplace, the people familiar with the figures said.

HHS spokeswoman Erin Shields Britt said Monday she couldn't confirm the enrollment numbers. She added that officials expected the largest share of enrollees to arrive later, citing the state health overhaul law in Massachusetts that rolled out in 2007.

"We have always anticipated that initial enrollment numbers would be low and increase over time, just as was the experience in Massachusetts, where only 0.3%, or 123 people paying premiums, enrolled in the first month. And, as we have said, the problems with the website will cause the numbers to be lower than initially anticipated," Ms. Shields Britt said.

In some cases, insurers have reported receiving duplicate enrollment forms and other data-integrity problems, but the people familiar with the matter said they believed the 40,000 to 50,000 figure reflected an accurate count of enrollments through late last week. The number reflects enrollment data sent to insurers from the marketplace.

The figure doesn't include people in the 36 states who used the federal website to learn if they qualified for Medicaid, a federal-state health program for low-income people.

Medicaid is being expanded in some of those states. The federal website cannot yet transfer information to the states about people who discover on HealthCare.gov that they are Medicaid-eligible.

The figure represents an improvement from the website's first days. On Oct. 1, when it opened, only six people signed up for coverage, according to internal administration memos released by the House Oversight and Government Reform committee. By Oct. 3, 248 people had enrolled, the memos suggested.

"Given the problems we have witnessed and experienced, that [40,000 to 50,000] number is actually higher than I expected," said Cliff Gold, chief operating officer of CoOportunity Health, a nonprofit insurer offering plans in Nebraska and Iowa. CoOportunity has seen its daily enrollments tick up from the single digits last month to double digits this month. "We're encouraged that the numbers are going up, but it's still not a seamless experience by any means," Mr. Gold said.

Separately, 12 of the 14 states that are running their own exchanges have tallied roughly 49,000 enrollees, excluding most Medicaid beneficiaries, according to a report released Monday by Avalere Health, a consulting firm.

Supporters of the law say they expect the largest share of enrollees to arrive late this year.

The relatively low numbers aren't likely to relieve insurers' growing concerns as the problems drag on. "As a national number, it just seems like such a drop in the bucket," said Allan Einboden, chief executive of Scott & White Health Plan in Temple, Texas.

Democrats acknowledge that the window is closing to fix the website and smooth out the enrollment process. Jeffrey Zients, who was named by Mr. Obama late last month to lead the effort, has said the site would be repaired for "most users" by Nov. 30.

Doug Ulrich, a 59-year-old in Roanoke, Ill., said it took him half a dozen tries just to create a profile on HealthCare.gov. Late last month, he finally was able to review premiums for some plans.

Mr. Ulrich, who runs his own financial-planning firm, said he wanted to sign up by Dec. 15 but is hesitating because he also wants to review small-business plans. That part of the site isn't yet working.

"I've got a month to make a decision, and I don't even have the information available to me," Mr. Ulrich said.

The tight timeline has insurers worried.

Already, insurers have said their incoming enrollees from the federal exchange are significantly older than anticipated. Because the law bars insurers from charging unhealthy customers higher rates, insurers must attract young, healthy customers to offset the costs of people who use more medical services.

"It's important not to look simply at the number of people who enroll, but also the mix of people who are purchasing coverage," said Robert Zirkelbach, a spokesman for America's Health Insurance Plans, an industry group. "At the end of the day, what matters most is what does the enrollment picture look like over the entire six-month enrollment period" ending in March, he said.

Mr. Zirkelbach declined to comment on the current enrollment figures.

The administration hasn't said whether it will release demographic data such as ages when it announces the number of enrollees.

—Amy Schatz
contributed to this article.

Write to Christopher Weaver at christopher.weaver@wsj.com, Timothy W. Martin at timothy.martin@wsj.com and Louise Radnofsky at louise.radnofsky@wsj.com

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