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Will the White House hit their health care enrollment goal?

With the deadline for enrolling in state and federal health exchanges looming, the White House is pushing for more signups. Early signs show 10 million may enroll, which is higher than the White House’s revised estimate. Mary Agnes Carey of Kaiser Health News and Susan Dentzer, a health analyst, join Judy Woodruff.

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  • JUDY WOODRUFF:

    Sunday marks the deadline for enrolling in the state and federal health exchanges this year. The push is on once again to get people to sign up.

    There are signs that perhaps more than 10 million will enroll, fewer than initially expected, but better than a revised estimate showed.

    To fill us in on the latest, we're joined again by Mary Agnes Carey Of Kaiser Health News and Susan Dentzer. She's a health analyst for the "NewsHour."

    And it's good to see you both again.

    (CROSSTALK)

  • MARY AGNES CAREY, Kaiser Health News:

    Great to be back.

  • SUSAN DENTZER:

    Thank you.

  • JUDY WOODRUFF:

    Time to talk health care.

    So, Mary Agnes Carey, just overall, how has the process been going the second year?

  • MARY AGNES CAREY:

    Well, the Web site is a lot better. It actually works, and that's better for everyone trying to enroll.

    And the federal government said that right now we have got about 10 million people who have enrolled and picked a plan, most of those people, about 7.75 million, with the federal exchanges. That's in about 37 states, and the rest are from the state-run exchanges.

  • JUDY WOODRUFF:

    So, how many of these who are signing up, how many of them are people who are returning, who were part of the system last year, and how many are new?

  • MARY AGNES CAREY:

    About 42 percent of those individuals are new enrollees and about 58 percent are re-enrolled.

    But what we don't know about that 58 percent that's important, did they actively re-enroll in their plan or did they pick a new plan? And that's important, because if you didn't go back and evaluate the price of the plan, the subsidy, how much it could buy, you could end up with a subsidy that buys less. You could end up in a plan that costs you more or costs you less if you are automatically reinvolved and didn't evaluate that for yourself.

  • JUDY WOODRUFF:

    So those are factors that are being watched?

  • MARY AGNES CAREY:

    Absolutely. And we will know more about it later in the year.

  • JUDY WOODRUFF:

    So, Susan, we were just — as we were saying, the administration has — the expectation number has shifted. It was 10 million. Then it was lowered, but now it looks like it's going to be better than that. What's going on?

  • SUSAN DENTZER:

    Well, it is the fact the case that the administration was expecting a maximum of 9.9 million to enroll in this open enrollment period, and it looks like we overshot that. It looks it is higher than 10 million.

    That's still lower than what others had estimated, including the Congressional Budget Office, which was estimating 12 million enrollees. But it looks like we will probably come in about in the middle, 10 million, 11 million people.

  • JUDY WOODRUFF:

    Why do they think it isn't higher? Is there — are they pinpointing what the challenges still are out there?

  • SUSAN DENTZER:

    Well, for one thing, it's hard to get people who haven't already had coverage to sign up. We know that that's the case.

    We also know that the Congressional Budget Office, for example, was expecting more employers to drop coverage and send their workers to exchanges, and that hasn't happened. Employers have actually stuck with their coverage. So that accounts for the Congressional Budget Office lowering its estimates about how many people would actually buy coverage through the exchanges.

  • JUDY WOODRUFF:

    And I know you have been looking at gender as well. You're seeing more women signing up than men? What's that about?

  • SUSAN DENTZER:

    It's fascinating. For the second year running, about 10 percentage points more women are signing up than men. This year, it's about 55 percent of the enrollees are women, 45 percent are men.

    Now, we don't have any reason to believe that more women are uninsured than men, so what explains this? Nobody really knows. People fall back on explanations like, well, women just care more about health and health care sometimes, and they are the primary buyers of health care for their families. Maybe that explains it.

  • JUDY WOODRUFF:

    More contentious?

  • SUSAN DENTZER:

    Well, and what we also see, interestingly, is of people who got covered last year who actually used their coverage, the signs are that a lot of the people who used their coverage were older women with chronic illness.

    So these are women who really needed coverage and they're using it. They're using it to get care for conditions that they have.

  • JUDY WOODRUFF:

    Now, Mary Agnes, you looked especially at Latinos and how the sign-up is going among that group. What did you find?

  • MARY AGNES CAREY:

    It's improving.

    This is a key demographic for the health law. They tend to be younger and healthier. These are people you want in the risk pool. And the Department of Health and Human Services decided to donate — to devote, rather, a third of its media budget this year to Latino outreach and enrollment vs. 10 percent last year.

    But it's still kind of a rough road for a variety of reasons. Like many people who haven't had health insurance before, many Latinos are confused about the process. They're trying to work their way through deductibles and co-pays and premiums and so on.

    Many people I spoke with who are uninsured now, Latinos, said, in the past, we just paid cash. So, even with a premium subsidy, they're wondering whether it's worth their while in some cases to enroll. But they're definitely the focus of outreach in enrollment. There are many events across the country focused on this demographic group.

  • JUDY WOODRUFF:

    So, you mentioned the subsidy.

    Hanging out there is the realization — and you both talked to us about this — that the tax penalty is out there for people who don't sign up, Susan. It's going up. That's on the one hand. On the other hand, we're looking at the possibility — or the prospect of the Supreme Court looking at a case which could end up with these subsidies that Mary Agnes just mentioned being declared unconstitutional.

    So, how are people, how are the experts dealing with all this?

  • SUSAN DENTZER:

    Well, people are focusing on the fact that the penalties do go up, as you said, for — there are different ways to calculate the penalty, but more or less the penalties for not having coverage in 2015 are two to three times higher than they were the first year around.

    For example, one level of calculating it, individual penalty went from $95 in 2014 to $325 in 2015, so dramatic jump. So there is that issue. We will get — next month, the Supreme Court will hear arguments on the case, King vs. Burwell, that you're alluding to. And in fact that would — that is going to have the court look at this issue of whether subsidies that go to help purchase coverage apply to coverage purchased through these state-based exchanges or through all the exchanges, including the federal ones.

  • JUDY WOODRUFF:

    Right.

    So, just quickly, Mary Agnes, creating kind of a push-pull going on here? Sign up, because you will be penalized if you don't. On the other hand, the whole thing could change.

  • MARY AGNES CAREY:

    Right.

    And the thing about this is, a lot of people won't even know about the penalty until they go to file their taxes, if they haven't paid attention to Affordable Care Act in enrollment. I talked to people at — recently who were saying they didn't even realize that there was this mandate to purchase coverage until they went up to sign up for their taxes.

  • JUDY WOODRUFF:

    Well, it's fascinating. One more check-in. And I know we're going to be talking to both of you again.

    Mary Agnes Carey, Susan Dentzer, thank you.

  • MARY AGNES CAREY:

    Thank you.

  • SUSAN DENTZER:

    Thanks, Judy

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