While the Patient Protection and Affordable Care Act (ACA) has succeeded in providing health coverage to millions of Americans, certain holdouts are proving more difficult to insure. The U.S. Dept. of Health and Human Services (HHS) estimates that by the end of 2016, the total number of insured people nationwide will be about 10 million. This represents an increase of about 1 million sign-ups from 2015.
And while any increases are positive, this number is lower than the more than 20 million forecast by the Congressional Budget Office (CBO). The 10 million beneficiaries are those that both purchased plans and paid their premiums, whether through state-run exchanges or the federally facilitated Marketplace. This group is comprised of uninsured people who are eligible to purchase coverage on the federal and state health exchanges. The HHS released a report detailing the group’s demographics. Among these findings:
- About 57 percent are male.
- Almost half are between 18 and 34.
- More than one-third are minorities; about 19 percent are Hispanic, 14 percent are African-American and 2 percent are Asian.
- Almost 40 percent have families earning between 139 and 250 percent of the Federal Poverty Level (FPL); about $30,000 to $60,000 for a family of four.
- Almost eight in 10 have incomes that may qualify them for financial assistance.
- 80 percent have less than $1,000 in savings.
Enrollment efforts should still yield success
Downplaying the lower-than-expected numbers, the Obama Administration believes that enrollment will increase over time. Richard Frank, HHS’ assistant secretary for planning and evaluation, states that they will be “seeing a much longer path” to getting people insured. Sylvia Matthews Burwell, the HHS Secretary, said that the agency expects more than 25 percent of these uninsured and eligible people will purchase coverage on the federal and state health exchanges during the upcoming Open Enrollment Period (OEP). The 2016 OEP runs from Nov. 1, 2015, through Jan. 1, 2016.
Burwell does, however, admit that the other 75 percent are “a little harder to reach.” The agency believes that these smaller estimates stem from the fact that fewer companies are planning to drop coverage than originally expected. In addition, fewer employees have made the move to purchase plans through the exchanges. The pricing of the marketplace plans may play a part, as well.
But going without coverage takes its own financial toll, as the Affordable Care Act (ACA) requires Americans to purchase health insurance during the OEP. If not, they face an IRS-imposed penalty; in 2016, this will be $695 for individuals and $347.50 per child, or 2.5 percent of your income, whichever is greater.
Even with the penalty, some uninsured Americans still needs persuading. In light of this, the HHS is committing its efforts to reach those 10.5 million who qualify for policies through the exchanges. Burwell says that the agency will target this group during the OEP. The HHS plans on boosting its marketing in communities with large uninsured numbers, such as Atlanta, Texas, Florida and Northern New Jersey.