HHS Secretary: Upcoming Enrollment Efforts Are Pivotal for Affordable Care Act

Health care law is having a bumpy ride

Rate hikes are likely on the way for plans offered on online insurance exchanges, or marketplaces, created by the Patient Protection and Affordable Care Act (PACA), according to a report from Kaiser Health News (KHN). Consumers’ out-of-pocket costs are expected to climb, and some major insurers have already pulled out.

In a statement to the press, Health and Human Services Secretary Sylvia Burwell acknowledged that the PPACA’s fourth enrollment season, scheduled to begin on November 1 and run until January 31, is a pivotal time for President Obama’s signature domestic policy achievement.

While the PPACA hasn’t been a predominant issue in the current election season, it has been at the center of a bitter fight between Republicans and Democrats since it was narrowly passed in 2010, according to the KHN report. The House of Representatives has voted more than 60 times to repeal all or part of the measure. The act has survived a number of court challenges but faces others.

Enrollment in the state and federal marketplaces is expected to grow by approximately one million people next year—from about 12.7 million to 13.8 million, according to recent federal estimates. The number of consumers who actually pay premiums and stay in the market is expected to average about 10.5 million per month this year and about 11.4 million per month in 2017.

This year’s enrollment period is focused on signing up healthier consumers, particularly those between the ages of 18 and 34, who tend to have fewer ailments. Consumers will also be reminded of the penalty for not having coverage, which for adults in 2016 is $695 or 2.5% of income, whichever is greater. The flat penalty will be adjusted for inflation in 2017.

The outcome of the November elections may determine the future of the PPACA as much as the willingness of insurers to offer coverage and consumers to enroll in the plans, the KHN article notes. Republican presidential nominee Donald Trump has promised to repeal and replace the act, whereas Democratic nominee Hillary Clinton has said she wants to make it more affordable for consumers who don’t qualify for subsidies.

Burwell has called on Congress to work with her and the Obama administration to make needed changes to the act. “To make more substantial changes, like a public option to encourage competition, we’ll need cooperation from Congress,” she said. 

So far, three major insurers––Aetna, UnitedHealth Group, and Humana––have pulled out of the exchanges. Aetna reported a loss of $430 million in the first half of 2016.

Sources: Kaiser Health News; October 19, 2016; and NPR; August 16, 2016.