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Crush of Obamacare sign-ups expected before deadline as pandemic rages

The website for HealthCare.gov
The website for HealthCare.gov. Tuesday is the open-enrollment deadline for coverage that starts Jan. 1 in most states.
(U.S. Centers for Medicare & Medicaid Service)

A crush of sign-ups expected before Tuesday’s end-of-day deadline for open enrollment in HealthCare.gov could help solidify the standing of Obamacare as an improbable survivor of the Trump presidency.

In 36 states that use HealthCare.gov, Tuesday is the last day for coverage that starts Jan. 1, while another 14 states and Washington, D.C., have later deadlines. Analysts and advocates who follow the annual insurance sign-ups say interest has grown stronger amid the spiraling COVID-19 pandemic.

Also, the legal cloud hanging over the Affordable Care Act seemed to start lifting last month when Supreme Court justices gave a skeptical reception to the latest challenge from the Trump administration and conservative-led states seeking to overturn the law in its entirety.

“The safety net is working,” said Chris Sloan of the consulting firm Avalere Health.

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He added that, when final numbers are released next year, the ACA could surpass its current enrollment of 11.4 million people. “I think it’s just reflective of the need being greater for people who have lost their jobs and need to find some other form of health insurance,” Sloan said.

The insurance markets offer taxpayer-subsidized private plans to people who don’t have job-based coverage. Insurers cannot turn away customers with pre-existing medical conditions. Medicaid expansion, another component of the health law, covers about 12 million people.

Republicans, who’ve promised since 2010 to ‘repeal and replace’ Obamacare, now are frantically trying to change the topic as voters’ support for the law has grown.

Of some 28 million uninsured Americans before the pandemic, the nonpartisan Kaiser Family Foundation estimates that more than 16 million were eligible for some form of subsidized coverage through the Affordable Care Act.

Stephanie Burton, a solo practitioner lawyer from Kansas City, Mo., said she recently renewed her coverage for 2021. For about $150 a month, after subsidies, Burton is also able to cover two young-adult children as they negotiate their transition to self-sufficiency in a shaky economy.

But Burton said she’s noticed that the annual enrollment season gets very little promotion. After Trump failed to repeal former President Obama’s signature law, not even the rising need for coverage amid coronavirus layoffs has persuaded his administration to rethink its opposition. Trump administration officials say what they have done is to focus on the smooth operation of the HealthCare.gov website for those who may want the coverage.

“Since I’ve always had it, I get reminders by email,” said Burton. “There are a lot of people who may not even know how to find this information.”

These four charts trace the sudden improvement in health coverage for individuals in Obamacare

That’s expected to change under the incoming Biden administration, which plans to build on the health law to expand coverage to more than 30 million who still lack it.

Some former Obama officials who closely monitor the Trump administration’s operation of the program say they have reason to hope in this sign-up season.

Joshua Peck, who used to be the chief marketing officer for Obamacare, said traffic is clearly up from current customers renewing their coverage, and the number of new consumers is tracking with previous years.

“It gives us reason to think that the end of this open-enrollment period could be a strong one,” said Peck. “We’re cautiously optimistic.”

But Tuesday could get nerve-racking for procrastinators because deadline day usually brings long waits for personal assistance through the call center and the website may run more slowly. Typically, people who start the enrollment process before the end of deadline day are given a chance to complete it.


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