The federal government expects only about 9 million people to sign up for health insurance on the new online exchanges this year — four million fewer than projected just this spring.
But officials say they are “confident” the system won’t crash when it opens this coming Saturday the way it did a year ago.
“We are confident that we will have a successful open enrollment,” Health and Human Services Secretary Sylvia Burwell said at an event sponsored by the pro-administration Center for American Progress think-tank.
Final numbers show that just over 7 million people signed up for health insurance on the exchanges this year. Just last April, the Congressional Budget Office projected 13 million people would sign up during this coming year’s open enrollment period, which starts Saturday.
“We are confident that we will have a successful open enrollment."
But the Health and Human Services Department dialed that back considerably Monday.
“What we did was, we have this many people enrolled,” Burwell said. “How many of these people do we think will re-enroll?” She said HHS determined that 83 percent of those now insured on the exchanges would re-enroll this year. Then they calculated how many new people would sign up to make a projection. “We think that range is about 9 million to 9.9 million,” Burwell said.
HHS said the CBO numbers didn’t take into account a “ramping up” period. Officials who asked not to be named struggled to explain what this meant on a conference call with reporters. They suggested that CBO projections assumed more people would sign up more quickly than real-life experience shows.
“CBO assumes that enrollment will ramp up to that steady state in just over three years, which generates an estimate of 13 million enrollees in 2015, 24 million in 2016, and 25 million thereafter,” HHS said in a statement.
But that’s not really right, HHS said.
“If one extends CBO’s ramp-up from three years to four or five years ... the estimate of 2015 Marketplace enrollment becomes approximately 11.5 million or approximately 9 million (respectively),” the statement adds.
Now, HHS says, it will measure success not by numbers, but simply on whether more people are signing up. “We will measure our success by whether we are making continued progress in reducing the number of uninsured Americans. We will continue to work to decrease the number of uninsured Americans and expect the number to continue to decline,” HHS said.
Burwell promised the site would work better than it did last year, when HealthCare.gov crashed the moment it opened on Oct. 1 and didn’t really work properly for week. The administration ended up having to extend the sign-up period to April.
“Things are simpler, faster and more intuitive,” Burwell promised. She said her department had tested the site more thoroughly. “Last year our testing was 10 days. This year our testing is five weeks,” she said. Officials admitted last year they rushed out HealthCare.gov without adequate testing.
The site is open for “window shopping” now. People won’t have to work as hard to sign up, she said. For instance, people who are renewing their plans won’t have to manually enter information, with many pages “pre-populated” with details such as home address, and just 16 screens to page through, compared to 76 last year.
HHS says 32 million Americans now lack health insurance, about a quarter fewer than this time last year. The exchanges are a centerpiece of the Affordable Care Act, widely known as Obamacare, which is designed to get more Americans covered by health insurance and to improve coverage.
Republicans have pledged to repeal the law, although most experts say they really cannot, even with new GOP control of the Senate after last week's elections.