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12.7 million signed up for Obama health care law, beating expectations

WASHINGTON — Still facing political jeopardy, President Barack Obama’s health care law beat expectations by earning solid sign-ups this year, according to figures released Thursday by the administration.

About 12.7 million people signed up for individual private insurance policies or renewed their coverage for 2016, said Health and Human Services Secretary Sylvia M. Burwell. That means Republicans running in this year’s elections may find it harder to deliver on their promise of repeal, while Democrats may yet be able to tap the newly insured as a voting constituency.

The health care law “is helping millions of people and has become an important part of health care in America,” Burwell said. The coverage “is a product people do want and need.”

Expectations were low at the start of open enrollment on Nov. 1. Premiums have been going up, and many of the remaining uninsured are considered skeptics.

The 12.7 million number falls right in the middle of the administration’s projection of 11 million to 14 million initial enrollments through HealthCare.gov and state-run counterparts. The administration says this year’s initial numbers are more accurate because early cancellations have been winnowed out.

But enrollment tends to dwindle as the year goes on. Some people leave for employer coverage while other customers can’t keep up with the costs, even while receiving considerable financial help. Others run into problems with the law’s complicated paperwork and lose their subsidies.

Burwell has set customer retention as the ultimate goal. Her target is 10 million consumers still signed up and paying premiums at the end of the year. With a cushion at the start, the administration seems on track to reach that goal in Obama’s final year in office.

This year was the third sign-up season for the Affordable Care Act, and different challenges emerged. The problem wasn’t the HealthCare.gov website, which is faster, more reliable and easier to use. The issues had to do with the cost of coverage, the motivations of millions of people who remain uninsured, and the sometimes mind-boggling complexity of the system created by Obama’s signature law.

Premiums went up for the private, taxpayer-subsidized coverage sold through HealthCare.gov and state insurance markets. Many of the more than 10 million eligible uninsured Americans tended to be younger people on tight budgets, with rent, education loans and car payments to juggle.

The 2016 enrollment number surpassed last year’s mark of nearly 11.7 million sign-ups.

Some insurers say customers appeared to be better informed and more engaged this year. Instead of a big spike on the Jan. 31 sign-up deadline, insurers say they saw steady traffic throughout last week.

Some procrastinators may have been swayed by a sharp increase in fines on those who remain uninsured. For 2016, the penalty will rise to $695 or 2.5 percent of taxable income, whichever is higher. The nonpartisan Kaiser Family Foundation estimates the average 2016 penalty at $969 per uninsured household.

Exemptions from the penalty are available for low income and other extenuating circumstances, but the administration says there will be no second chance to enroll for people who learn about the penalty when they file their taxes.

The health law has added coverage in two major ways: Online insurance markets like HealthCare.gov offer subsidized private plans to people who don’t have coverage on the job, and states have the option of a Medicaid expansion aimed at low-income adults. Thirty-one states, plus Washington, D.C., have expanded their Medicaid programs.

More than 14 percent of Americans were uninsured in 2013 before the health care law’s big coverage expansion. That share dropped to 9 percent last year, according to the government. More than 16 million people gained coverage from the end of 2013 to the middle of last year. But a recently major independent survey suggests those historic gains could be slowing.

Republicans remain committed to repealing “Obamacare,” and every GOP presidential candidate has vowed to deliver on that promise.

Among the Democratic contenders, Hillary Clinton would make changes geared to improving the health care law, while Vermont Sen. Bernie Sanders would incorporate all current health programs into a new government-run system that would also absorb employer-provided and individually purchased insurance.

Polls show the public remains divided over the health care law.

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