Insurance enrollment makes up for the health care exchange's early problems, but much work remains.
WASHINGTON — More than 4.2 million people have signed up for private health insurance through the state and federal exchanges, Health and Human Services officials announced Tuesday.
The latest statistics show the gulf between the original estimate of 7 million new customers from the Congressional Budget Office and how many people have come forward to comply with the requirement that those without insurance buy it or pay a fine.
They provide mixed messages in terms of who is buying insurance and how quickly. For example, 942,000 people signed up for private plans in February, a drop from 1,146,000 in January. That's about 3,300 a day fewer in February. More than 1 million people signed up in both December and January.
"What we're finding is that as more Americans find just how affordable marketplace insurance can be, more are enrolling," HHS Secretary Kathleen Sebelius said. "There's still time for others to sign up. They'll want to do it today, before that March 31 deadline."
Caroline Pearson, a vice president at Avalere Health, an advisory company, predicted the final numbers will be about 5.4 million, based on what the company saw when people enrolled in the Medicare Part D prescription drug program.
"We expected things to continue to accelerate, and we're seeing a leveling off," Pearson said, adding that it's "not impossible" to reach 6 million. "There's certainly more than enough people eligible for subsidized coverage who would benefit; it's just a matter of reaching them."
Uninsured people can be harder to reach because they aren't in the health system, Pearson said.
Despite concerns about enrollment, the government will not extend the March 31 deadline, said Michael Hash, director of HHS's Office of Health Reform. The law, Hash said, required the deadline to be set by last June. "We do not believe we have the authority to extend the deadline past that point," he said.
A higher percentage of people ages 18 to 34 — 27% — enrolled in insurance last month, an increase from 24% in the first three months the exchanges were open. The more younger, healthier people enroll the better because they pay more in premiums than they cost in health care expenses.
The numbers show people are choosing heftier, silver-level plans: About 63% of enrollees chose silver plans, while 18% chose the less expensive bronze plans. Eleven percent chose gold, 6% chose platinum and 1% picked bare-bones catastrophic plans. About 83% were eligible for financial help paying their premiums.
As expected, more women have signed up than men: Women make up 55% of the total, and men make up 45%.
The Obama administration is digging out of the hole created by HealthCare.gov's flawed opening Oct. 1, when millions of potential customers could not navigate the site because of multiple flaws that weren't fixed until Nov. 30. Those problems were why the CBO reduced its estimate for new customers to 6 million.
Julie Bataille, the Centers for Medicare and Medicaid Services communication director, said the government has geared up for an anticipated surge of enrollees as the deadline approaches.
"Today's numbers show that our aggressive outreach is making a difference," she said.
President Obama and his aides have stepped up their promotion of the exchanges and the need to enroll in insurance. Last week, Obama conducted a town hall meeting with Latino-oriented TV networks. Tuesday, the White House touted an online interview Obama made with actor Zach Galifianakis to promote enrollment. Bataille said about 19,000 people watched the video, then visited HealthCare.gov.
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