With one open enrollment period closed and another beginning, HealthCare.gov and state exchanges have sold about 20 percent of the number of health plans that federal budget officials think is enough for a sustainable risk pool.
HealthCare.gov sold some 1.1 million health plans for Jan. 1 coverage from October through December 24, about 90 percent of them in the last month, Centers for Medicare & Medicaid Services (CMS) administrator Marilyn Tavenner wrote in a blog post.
The federal insurance exchange and many of the state exchanges are now hosting open enrollment through March 31, the deadline for obtaining coverage to meet the individual mandate for the 2014 tax year. By then, the Congressional Budget Office estimates, all of the country's 51 exchanges should have enrolled at least 7 million Americans in private health plans and 8 million more in Medicaid and CHIP.
"We are in the middle of a sustained, six-month open enrollment period," Tavenner explained in her blog, "much like other historic implementation efforts we've seen in Massachusetts and Medicare Part D."
In Medicaid so far, eligibility determinations in October and November totaled 3.9 million and probably a few thousand more in December, meaning that the exchanges have another three months to enroll about 5 million more people. For the 1.1 million health plan enrollments, it's not clear how many consumers have made their first premium payments; many now have until January 10.
While some analysts have said that the CBO's projections are not necessarily the number needed for the exchange risk pools to sustain themselves, the federal government is trying to ensure that the flagship Healthcare.gov is able to enroll thousands of people at once. On December 23, Tavenner said, the site supported 83,000 concurrent users.
On the consumer outreach front, with the support of the firm Weber Shandwick, HHS is hoping to use digital media to reach a broad cross section of the country, young and old. The Twitter campaign #GetCovered is trying to pitch the consumer affordability of the new plans with the stories of people who've enrolled, such as Jacob from Arkansas: "My family and I will be saving about $120 a month with much better coverage, plus dental"; and Diane from Michigan: "I wasn't going to get coverage unless I completely changed my career. I wouldn't be able to do the work I really enjoy."
Off of the web, for those without personal devices or home Internet, Healthcare.gov and state exchanges are trying to reach people in libraries, public transit stations and anywhere navigators or consumer assisters can be hosted.
Local healthcare organizations are also doing their own outreach, like the Maine Community Health Options, the new ACA-supported CO-OP, which has bought city bus ads, hosted public events and extended enrollment for Jan. 1 coverage until Dec. 31. In Philadelphia, Independence Blue Cross is sponsoring an ice rink this winter, underwriting a new public radio program and inviting residents to learn about enrollment options in a mobile truck equipped with iPads.