No Extension to Insurance Exchange Open Enrollment, Sebelius Says

The Obama administration will not extend the open enrollment period beyond March 31 for U.S. residents to enroll in coverage through the Affordable Care Act's insurance exchanges, according to HHS Secretary Kathleen Sebelius, the New York Times reports (Pear, New York Times, 3/12).

Sebelius made the announcement Tuesday during a House Ways and Means Committee hearing on the Obama administration's fiscal year 2015 budget proposal (Corbett Dooren/Radnofsky, Wall Street Journal, 3/12). Sebelius was expected to discuss the budget plan's health care-related proposals but ended up fielding several questions about the ACA and exchanges, according to Modern Healthcare's "Vital Signs" (Zigmond, "Vital Signs," Modern Healthcare, 3/12).

Background

On Tuesday, HHS announced that a total of 4.2 million U.S. residents had enrolled in private health plans through the ACA's federal and state insurance exchanges by the end of February. Observers said that the slowdown in enrollment trends for February likely mean that the administration will not be able to reach its total enrollment goal for the six-month open enrollment period.

A memo circulated among federal health officials in September 2013 set targets of having 5.6 million people enrolled by the end of February and as many as seven million people enrolled by the end of March (California Healthline, 3/12). At Wednesday's hearing, Sebelius declined to say whether the administration is still aiming to meet the higher figure (New York Times, 3/12).

No Delay to Individual Mandate, Penalties

Sebelius also said the White House will not delay enforcement of the individual mandate or its penalties ("Vital Signs," Modern Healthcare, 3/12).

Under the ACA, most U.S. residents who do not have insurance coverage in 2014 will face a tax penalty of either $95 or a fine of up to 1% of their taxable income. The penalty increases to $325 or 2% of taxable income in 2015 (California Healthline, 3/3).

2015 Health Premiums Could Increase Slightly

During the hearing, Sebelius acknowledged that insurance premiums for 2015 could rise slightly but added that costs would increase more slowly than they have in the past.

According to the Wall Street Journal, 2015 premiums are projected to increase, particularly because of lower-than-expected enrollment of young, healthy individuals. So far, only one-quarter of those who have enrolled in the exchanges' plans are between ages 18 and 34, which is significantly short of the 40% target that analysts say will be necessary to stabilize premium costs (Wall Street Journal, 3/12).

However, Sebelius said the increases would be "far less significant than what they were prior" to the ACA's implementation because of measures -- like risk corridors -- that are built into the law to keep premiums down (Easley, "Healthwatch," The Hill, 3/12).

Still No Data on How Many Paid ACA Premiums

During the hearing, committee members pressed Sebelius to disclose how many exchange enrollees have paid their first month's premiums, which is key in determining how many individuals actually have gained coverage and benefit from the law, Politico reports.

Sebelius said she could not answer the question because she did not know the information. She explained that HHS receives "aggregate data" from insurers about who has paid, but that data is not detailed enough to answer the question.

Sebelius declined to say whether she has requested more detailed information from insurers. She added that HHS also could not obtain the detailed payment data until its exchange technology system can perform automatic accounting, which likely would not be completed until this summer (Norman, Politico, 3/12).

Increased IPAB Savings

Rep. Paul Ryan (R-Wis.) questioned Sebelius about the FY 2015 budget proposal's projection that the ACA's Independent Payment Advisory Board could save the federal government three times what it did in 2014, Kaiser Health News' "Capsules" reports.

He noted that the 15-member panel has not convened for any meetings since its members have not even been nominated yet. Yet, the budget proposal estimated that IPAB could save about $12.9 billion over the next 10 years, compared with $4 billion in estimated in the administration's FY 2014 budget proposal.

Sebelius said the projected increase comes from actuarial estimates of rising Medicare costs that were outlined in the budget proposal's decade-long projections. However, she noted that HHS officials do not consider the estimates to be accurate since Medicare spending growth has slowed in recent years (Agnes Carey, "Capsules," Kaiser Health News, 3/13).