Analysis finds PPACA won’t hit enrollment target

By BenefitsPro


By Kathryn Mayer

The administration just announced that 4.2 million people have enrolled in coverage under the Patient Protection and Affordable Care Act.

And new analysis expects that number will surge with just three weeks left in open enrollment.

Consulting firm Avalere Health said Wednesday that exchange enrollment is on track to reach 5.4 million by the end of March.

Though that projection is ambitious for the final few weeks, that number still falls short of Congressional Budget Office estimates that 6 million people will enroll in exchanges in 2014.

Health care experts have warned that enrolling millions of Americans is vital to the success of the law, though Avalere Health downplayed that notion, saying having healthier individuals enroll is more important.

“The administration is conducting aggressive outreach in March in an effort to boost enrollment,” said Caroline Pearson, vice president at Avalere. “However, success of exchanges in 2014 will depend less on the size of the market and more on the risk profile of enrollees.”

Avalere’s analysis is based on analysis of the first open enrollment period in Medicare Part D in 2006, when 22 percent of voluntary sign-ups took place in the last month.

“If exchanges follow the same pattern, Avalere projects that 1.2 [million] people would enroll in coverage in the month of March,” Avalere’s report said.

Avalere also noted that in January and February, enrollment in federally run exchanges increased faster than enrollment in state-based exchanges, as federal exchanges recovered from early setbacks caused by Healthcare.gov.

California, Florida, Idaho, North Carolina and Washington lead the states in terms of enrollment, having enrolled more than the number of people expected to sign-up for exchange coverage in 2014, the consulting firm said. Meanwhile, Hawaii, Massachusetts and the District of Columbia are struggling to meet enrollment projections.

Avalere Health CEO Dan Mendelson said that with the fixes to the federal exchanges, they now “surpass some states in terms of ease of consumer access, eligibility and functionality.”

Initially, the administration said they would have 7 million Americans enrolled under PPACA this year, but has since backed away from the projection. The law’s slow start is often blamed by website problems that plagued HealthCare.gov for months, but a lack of awareness of PPACA has also plagued its success.

Under PPACA, virtually all Americans must buy health insurance by March 31. Those who don’t have to pay a tax penalty under the law and will be forced to wait until next year’s open enrollment to get insurance — unless they experience a qualifying event such as marriage in the interim.

In 2014, the penalty is $95, or 1 percent of a person’s income, whichever is higher. The penalty escalates in subsequent years.

Originally published on BenefitsPro.com