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Five days before the March 31 enrollment deadline, the Obama administration says that Americans will have more time to sign up on federal health care exchanges if they’ve begun but can’t finish the process on time. Gwen Ifill talks to Mary Agnes Carey of Kaiser Health News and Ceci Connolly of PricewaterhouseCoopers Health Research Institute for a closer look at the extension and its critics.
The Obama administration's decision today to extend the date for enrollment in the federal health care exchanges comes just five days before the March 31 deadline. The extension is the latest part of a yearlong push to try to get those 6 million people signed up.
For an update on what's working and what's not, we turn to Mary Agnes Carey of Kaiser Health News, an independent organization, and Ceci Connolly, the managing director of the Health Institute at PricewaterhouseCoopers, which works with insurers and other companies in the health care industry.
Mary Agnes, what's the justification for this latest delay? This is not the first time we have seen a delay.
MARY AGNES CAREY, Kaiser Health News:
They say it's basically akin to Election Day. If you're at the polling places by the time it closes and you're in line, you get to complete the process. They say they simply want to allow people that are already in the process to complete it.
But, as you know, you get to self-attest. You get to tell government, yes, I tried to enroll before March 31, but it didn't work, so I need more time.
Well, let's go back for a second. Why would they need to extend it? Is it because they're not hitting your numbers, because you're not hitting getting the people they want to enroll?
MARY AGNES CAREY:
While they say they have made a lot of improvements to the Web site and things are working smoothly, Web site traffic is up. They haven't had problems. Just in case this last-minute surge that they expect, if they have any problems with the site, any difficulties for people, they want to make sure they can complete the application.
Ceci, we have been watching the push the administration is putting, going on comedy programs, doing radio, Spanish-language interviews, you name it. As a result, who has enrolled and who has not?
CECI CONNOLLY, PricewaterhouseCoopers Health Research Institute:
We're still watching for the breakdowns, Gwen, but we have been observing a shift in the enrollment patterns ever since things started bumpily on October the 1st.
For the first few months, the enrollment tended to be somewhat older people, I would over 40, up into their 50s. Since January, we have seen an increase in younger adults, 18-34 age group, and there's so much attention being placed on those young invincibles right now because we believe that they're probably healthier and they're going to kind of spread out the risk. Right now, it looks like about…
They're the ones who will pay for the actual health care.
Absolutely, and probably not have too many health expenses in the near future. We're at about 25 percent to 27 percent of total enrollment is that age group.
Let's go back to this self-attesting part of this extension today, Mary Agnes, because it sounds like if you just weren't thinking about it, if you were just plain late and you decide to go on the health care site on April 2 for the first time, you can just say you were trying to apply, and nobody's going to check that?
Well, that's what they were asked repeatedly. How do you verify it? They say that they believe that most people are truthful on this kind of application and will be truthful about the fact that they were in before the 31st of March.
But, just as you said, that is the criticism. You can get on well after that and simply check the box on the application.
John Boehner says a rule is a rule is a rule, except in the health care law? Does it keep fluctuating?
Well, this is the problem. You have had so many extensions. The employer mandate has been extended. The risk pools have been extended. There's been a variety of extensions that no one — in John Boehner's opinion, no one really takes them seriously anymore.
Let's take one population group that they have been targeting, Ceci, and that's Latinos. When this all started, you talk about the bumbly Web site — the Spanish-language version wasn't even operational. And they have been since been working very hard at that population.
Is there any evidence that they're coming around?
Yes, but slow and small, Gwen.
We knew going in that that was always going to be a challenging target population, not only because of language barriers, but also, in that population, you sometimes see some skepticism about signing up for something that looks like a government program.
We have seen that they can be hard to reach if maybe they don't have a home computer. They may not be on the Internet getting e-mail messages, getting social media messages. So you have got to get into the community, knock on doors, go to churches, et cetera, to reach these individuals.
Mary Agnes, is there also concern — I noticed in one of the president's interviews, he specifically said immigration is not going to come after you if you sign up for this. Is that also a concern here?
That has definitely been a concern, that somehow that if you're in the country, you will be penalized if you apply for health care coverage. The president's gone out of his way to reassure folks that's not the case.
Is the six million goal in reach?
It's definitely in reach, but…
What's the last we heard?
Well, they still are saying six million. It was originally seven million. Then, when they had the problems with the Web site, the Congressional Budget Office put the number at six million.
But the key factor here is the risk pool. As Ceci noted, if you get younger, healthier people in, that helps. You could have older, healthier people in. It really depends on who is signed up and what is the experience with those people.
So, how are insurers responding to this? It seems like the ball keeps moving further and further away. That's not the kind of certainty that many businesspeople love.
Businesspeople certainly prefer certainty, Gwen.
But in this case, there's very little downside to today's announcement because they're going to get new — they're going to get additional paying customers. And that's always been why the insurance industry and hospitals have been relatively supportive of the Affordable Care Act. It is the prospect of many millions more new paying customers.
And there's a belief that, if we saw more of the older, sicker people sign up in the early months, that these extra weeks are just going to bring in younger and healthier. That's all positive for the insurance industry. So a couple extra weeks to bring in more young healthies, very good news for them.
Mary Agnes, Ceci just talked about more paying customers. Do we know yet — is there any measurement that's been handed out yet about whether people are actually paying premiums yet or whether they're just signed up?
We don't know that. That's a problem with this back end of the Web site. The front end is the consumer experience, you get on and you enroll. The back end is the information to the insurance company, and the insurance company responding to the government to say, who's enrolled, have they paid their first month's premium? And we're still waiting on those statistics.
We have, though, certainly, Gwen, been talking sort of individually to a number of insurers. And they're saying right now it's looking like 70 to 80 percent payment in those first few months, which is Comparable to what they see in any other insurance market.
So, so far, it appears to be tracking with normal business.
OK, a little news you can use.
If you are someone who has not signed up, you have been meaning to, you have been putting it off and you go online, what do you have to do? Is there a penalty that kicks in after April 15 now, or is something — is there never going to be a penalty because the line will keep changing?
Well, the penalty as exists now is $95 or 1 percent of income in the first year for an individual. And people often forget about that 1 percent of income, because it's whichever figure is higher.
So, that's certainly something to know, to think about. But if you haven't received — you haven't — you want to enroll in coverage, maybe not wait until the 31st. Go on the Web site today, look at it, see what your options are. Can you get a subsidy? There's all different sorts of coverage you can buy, different tiers of coverage. If you're under 30, you can get a catastrophic plan.
You might find something that works for you.
Ceci Connolly, Mary Agnes Carey of Kaiser Health News, PricewaterhouseCoopers, thank you both very much.
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