Insurers Dismayed Over Obamacare Rule Changes

At the last minute, the Obama administration gave consumers more time to sign up for health insurance starting Jan. 1. People will now have until the end of Christmas Eve, giving them an additional day. The administration hopes a late surge of enrollments will boost numbers, which have lagged far behind expectations. The insurance industry is hoping the same thing. But it is also expressing dismay over recent changes to the law that allow some people to opt out of the individual mandate or purchase plans otherwise prohibited under the law.

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Insurers are sounding more hopeful now that more people are signing up for coverage, but there is still some big questions about exactly who is signing up and how much they'll pay. Here's NPR's Jim Zarroli with that story.

JIM ZARROLI, BYLINE: Health insurance industry officials have made their unhappiness over the botched rollout of the Affordable Care Act clear, but the industry has a lot at stake over the success of Obamacare and these days, industry officials are beginning to breathe a bit easier about enrollments.

ROBERT ZIRKELBACH: There's no question that enrollments continue to increase and health plans have seen a lot of interest from consumers and their websites and at their call centers.

ZARROLI: Bob Zirkelbach is a spokesman for the industry lobbying group, America's Health Insurance plans. He says more people are successfully enrolling for coverage. Susan Millerick, a spokesperson for Aetna says enrollments finally appear to be at the levels the company expected when the act got underway.

SUSAN MILLERICK: Obviously, the October and November numbers were low because of the difficulties with the website and in December, the volumes started to recover more toward what we would've expected to be a normal level.

ZARROLI: Millerick also says the websites where consumers sign up for coverage are working better without as many of the errors and data flubs that plagued the system a few weeks ago.

MILLERICK: Across the board it's become better, more stable and the information flow is improving.

ZARROLI: And yet, Bob Zirkelbach says there's still work to do.

ZIRKELBACH: There has been progress made over the last several weeks to improve that data, but we're not where we need to be yet to ensure that those enrollment files are complete and accurate.

ZARROLI: Zirkelbach says ultimately what's important isn't just how many people are signing up for coverage, but who they are. The industry needs young healthy customers willing to pay into its risk pools. If they don't show up and the coverage is skewed towards sicker, costlier customers, it will throw off the industry's cost calculations.

ZIRKELBACH: It's not just the total number, but that balance that will ultimately determine how well these reforms work and what happens to healthcare costs and premiums down the road.

ZARROLI: People signing up for coverage can choose between several tiers of benefits and Brian Haile, senior vice president for healthcare policy at Jackson Hewitt, the tax preparations service, says he's heard from industry officials that a lot of people are leaning towards higher end policies.

BRIAN HAILE: I think we're surprised by the number of people who at least initially were choosing plans that were particularly higher value or had higher coverage.

ZARROLI: Haile says that could be because the people signing up tend to have health problems, but he says the evidence is just anecdotal right now. Haile says he believes that a lot of people who plan to get coverage haven't done so yet because they don't have the money right now.

HAILE: Most of the families that are uninsured are really struggling to put something under the holiday tree and not necessarily a health insurance card in their wallet by January 1.

ZARROLI: Haile says he thinks that will begin to change in another six weeks or so when consumers begin to collect their income tax refunds. And when they do, he says, they'll use the money to sign up for health insurance. Jim Zarroli, NPR News, New York.

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