(Bloomberg) Americans have more time to pay for their new Obamacare health plans, thanks to the
The deadline to enroll in plans that begin Jan. 1 is today for most of the U.S., a cutoff that remains firm even as the Obama administration has urged insurers to allow retroactive sign-ups into next month. The industry also balked at leniency for new customers who go to doctors or refill prescriptions not covered by their plans.
The success of the health overhaul relies on a diverse pool of customers where younger, healthier participants balance the costs of covering older, sicker people. Insurers say they cant make more concessions without putting themselves at risk that patients will wait and sign up only when they need care.
Its hard to be nice when it comes to the risk pool,
Controlling Costs
President
Enrollment had been sluggish, with just 365,000 people selecting private plans on the new state and federal government-run health exchanges through the end of November. Enrollment accelerated in December, Obama said at a Dec. 20 news conference, with more than 500,000 people in the 36 states served by the federal exchange selecting plans in the first three weeks of the month.
All told, millions of Americans despite the problems with the website are now poised to be covered by quality affordable health insurance come New Years Day, Obama said.
At least 3.9 million people have been determined eligible for Medicaid, the state-run health program for the poor, or for state childrens health programs since the exchanges opened Oct. 1, the U.S. Centers for Medicare and Medicaid Services said in a
Industry Concessions
Gaining concessions from the insurance industry would provide an additional boost, though the changes requested so far by Obama on retroactive enrollment and out-of-network coverage cut straight to the heart of how insurers manage costs.
As it is, theyre dealing with a lot of uncertainty,
Obama earlier pushed back a key application deadline, delayed a small-business health exchange and extended a program for high-risk pools of sick Americans. On Dec. 19, his administration said hundreds of thousands of people whose health plans are being canceled because their coverage doesnt meet Obamacare rules will be exempt next year from the health laws mandate that all Americans carry medical insurance.
Meeting Targets
Theyre trying to do everything possible to generate more enrollment, Mendelson said. They will be judged on enrollment at the end of the day. If they feel they can make these marginal modifications to enhance enrollment, theyre going to do it.
The administration had set a goal of signing up 7 million people through the new federal and state insurance marketplaces by the March 31 end of the six-month enrollment period.
Most of the flaws in the enrollment system have been fixed, the administration said. Officials said they sent more than 2 million reconciliation e-mails and made 600,000 phone calls to people who experienced difficulty signing up in October and November.
U.S. Health Secretary
Continued Care
Insurers say that theyll follow existing policies on whats known as continuity of care -- allowances made to new members so they dont have to change doctors or medicines while being treated for an illness. At Aetna, the third-biggest U.S. health insurer, new customers have as long as three months to transition to doctors and drugs included in the companys networks and formularies, said
The benefits and networks we offer on the exchanges were all filed and approved by the states where we participate, Michener said in an e-mail. To alter those plans would require approval by state regulators. We would also need to make significant systems changes and/or increase service support, which are not viable.
Serious Conditions
Continuity-of-care allowances are usually made for serious or long-term conditions such as cancer, pregnancy, mental illness, transplants and multistage surgery.
Joe Mondy, a spokesman for Bloomfield, Connecticut-based Cigna, said the company will abide by the Jan. 10 payment deadline and that we continue to review the administrations other requests. He didnt say when a decision would be made.
Matt Stearns, a spokesman for