4.2 million sign up for Obamacare as March enrollment deadline looms

About 4.2 million people have signed up for health care insurance through exchanges under the Affordable Care Act (ACA), a sign that enrollment numbers are slowly rising but still far short of the Obama administration’s goal of 7 million.

The shortfall is a blow for President Barack Obama and Democrats who have staked political capital on an often bitter fight for health care reform, as Obama’s presidency wanes and many Democratic lawmakers face an election year.

More than 940,000 people signed up in February, bringing the total to 4.2 million since registration opened five months ago, the Department of Health and Human Services (HHS) said. But the administration is scrambling to get more people to sign up before the March 31 deadline, after which uninsured people will be fined under the ACA.

“Over 4.2 million Americans have signed up for affordable plans through the Marketplace,” HHS Secretary Kathleen Sibelius said in a news release. “Now, during this final month of open enrollment our message to the American people is this: You still have time to get covered, but you’ll want to sign up today — the deadline is March 31st.”

Of those who have signed up, 1.6 million used state-run exchanges while the other 2.6 million used the federally run one. More than half are female, and 83 percent of those enrolled qualified for some form of financial assistance.

While the numbers are slowly increasing, only a quarter of the people enrolled are between the ages of 18-34 — a demographic that experts says is key to making the Affordable Care Act viable.

“It is a lower percentage than had been hoped, and this really may not bode well for the future if we continue to see the older and sick people sign up, because they will be getting more in payouts and claims than they’re putting into the system,” said Laura Adams, senior insurance analyst for insurancequotes.com.

“The fear with older consumers, who may have really been first to get the health insurance because they needed it the most, they are likely to certainly begin using the coverage and getting more payouts from doctor visits and hospital visits,” Adams told Al Jazeera.

Without younger people signing up for coverage, Adams said insurance companies may have no choice but to either raise premiums or only offer coverage in areas that have proven to be profitable.

Administration officials expect a surge in enrollment as the clock winds down and procrastinators are forced to sign up to avoid fines.

"Given what we know about past enrollment patterns for health care, we expect that even more (people) will sign up as we approach the March 31 deadline," Sebelius said.

Adams echoed those thoughts, noting that people often wait until the last moment to meet official deadlines like those for filing for taxes. But even if many holdouts sign up, it is unlikely to meet the goal of 7 million.

Obama appeared on comedian Zach Galifianakis’ satirical Internet talk show “Between Two Ferns” in an effort to encourage young people to sign up for coverage.

There are no plans to extend the March 31 deadline, but a January report from Bankrate.com said that more than half of Americans did not know when the deadline was, and more than 60 percent believed that it would be extended.

If people are not enrolled by March 31, they will face a fine of either $95 or 1 percent of their total income, whichever is higher, when they file their taxes next year.

Adams, the analyst at insurancequotes.com, said that for the majority of people the penalty will be much higher than $95, and they will likely see that amount deducted from their tax refund.

“Instead of their tax refund being $3,500, it may just be $3,000,” Adams said.

“It can really add up for consumers, and I think there will be a lot of sticker shock for people,” she said. “And I think the penalty is either going to be higher than people think, or they don’t even know that there is a penalty for not having health insurance.”

According to an analysis by The Associated Press, 13 states are ahead of their enrollment goals. Despite Republican politicians’ fierce resistance to the ACA, six of those states — Florida, Idaho, Maine, Michigan, North Carolina and Wisconsin — have Republican governors.

The HHS report released Tuesday did not include data showing how many people who have recently signed up for coverage were previously unemployed. There is also no data on how many people have actually paid their insurance premiums.

Robert Laszewski, a health care industry consultant, told the AP that without data on who has actually paid the bill, he has little confidence in the numbers.

"They are still reporting numbers that are inflated," he said.