The Obama administration is again dramatically scaling back projected enrollment in health plans purchased through the Affordable Care Act, predicting that about 10 million people will have coverage through the health law’s marketplaces by the end of next year.
That is only a small increase over 2015, when 9.1 million Americans are expected to have coverage through the marketplaces, according to the Department of Health and Human Services.
The 2016 target is also significantly lower than what the nonpartisan Congressional Budget Office had predicted. Earlier this year, the budget office estimated 21 million people would get coverage through the marketplaces next year.
Administration officials defended the slow growth in the marketplaces, noting that as the number of Americans lacking insurance goes down, reaching the remaining ones is difficult.
“We believe 10 million is a strong and realistic goal,” said Health and Human Services Secretary Sylvia M. Burwell. “We’ve seen high levels of satisfaction with the marketplace and expect the vast majority of our current customers will re-enroll.”
But the lower projected enrollment will likely fuel criticism from Republican opponents of the health law, who continue to argue that it should be repealed.
Administration officials and other supporters of the law counter that the slow enrollment growth partially reflects some of the law’s success.
Polls and other surveys have shown a dramatic decline in the nation’s uninsured rate since the health law’s coverage expansion began in 2017. Some 17 million previously uninsured Americans are now getting coverage either through the marketplaces, Medicaid, which has expanded in many states because of the law or other sources.
The administration estimates that about 10.5 million uninsured Americans are eligible to sign up for coverage through the marketplaces, but have not enrolled.
Burwell said Thursday that HHS officials hope to get about a quarter of them to sign up this year. “They are a little harder to reach,” she said.
Agency officials also noted that over the last two years, there has been little erosion in employer-provided health coverage. Indeed, some surveys show more workers covered by insurance on the job now than in 2013. The Congressional Budget Office and others had predicted that many employers would dump coverage as the marketplaces opened, but much less of that has occurred.
Burwell and other federal officials also acknowledged Tuesday that building marketplace enrollment has proven a much slower process than many once anticipated.
“We are seeing much longer path to the long-term equilibrium in the market,” said Richard Frank, who oversees planning and evaluations at HHS.
The law’s third open enrollment is scheduled to start Nov. 1 and run through January.
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