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WH: Ramp-up for Obamacare exchanges will be slower than expected

The White House expects 9.0 to 9.9 million will be covered by the exchanges in 2015 — significantly lower than 13 million initially projected by the CBO.
An insurance agent helps a woman purchase an insurance policy under the Affordable Care Act at the store setup in the Westland Mall on Nov. 14, 2013 in Hialeah, Fla. (Photo by Joe Raedle/Getty)
An insurance agent helps a woman purchase an insurance policy under the Affordable Care Act at the store setup in the Westland Mall on Nov. 14, 2013 in Hialeah, Fla.

The Obama administration expects that 9.0 to 9.9 million people will receive insurance through the Affordable Care Act's insurance exchanges in 2015, according to an analysis from the Department of Health and Human Services released on Monday. 

It’s significantly lower than the 13 million that the Congressional Budget Office had estimated would be enrolled next year, though higher than the 7.1 million who have been enrolled as of October 2014. Open enrollment for 2015 coverage on the exchanges will begin on November 15. 

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The administration said that its projections were lower because the CBO had completed its analysis “before final data on 2014 open enrollment was available.” It also said that recent data suggested there was “considerable uncertainty” there would be a large shift of consumers from employer-sponsored insurance and non-exchange individual insurance to the Obamacare exchanges, as CBO had predicted. 

As a result, the ramp-up won’t be as rapid as the CBO has predicted, the HHS memo concluded: "The long-run steady state may not be achieved for as much as five years."

HHS Secretary Sylvia Burwell said that the public shouldn’t judge the success of the Obamacare exchanges purely on the basis of enrollment numbers. “It’s not about the number—it’s about the analytics under the number,” she said at an event on Monday, pointing out the importance of looking at re-enrollment numbers.

Politically speaking, it would be a safer bet for the White House to go with more conservative enrollment projections. But the exchanges need a critical mass of participants—particularly healthy ones—to keep premiums down and to reduce the number of uninsured Americans. The White House met its goal of seven million enrolled in 2014 earlier this year. 

Those who are already enrolled in plans through the exchange will be automatically re-enrolled for 2015 coverage unless they decide otherwise. But there will be more insurers offering plans through the exchange next year, and those currently enrolled may see their premiums go up unless they switch insurance carriers, as the Wall Street Journal noted.

Burwell said it will be more challenging to convince new consumers to enroll in 2015. “The next group of people will be harder to reach,” she said. 

HHS has revamped and simplified the website for the next open enrollment period, expressing confidence that consumers would not experience the same technical difficulties that bogged down Healthcare.gov last year.

“Last year our testing was 10 days—this year our testing was five weeks,” said Burwell. She warned, however, that there would still be bumps along the way. "We will have outages, we will have downtime." 

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The website opened its “window-shopping” period on Sunday, which allows consumers to browse and price out different insurance plans, though they will not be able to enroll in 2015 plans until Saturday.