The Obama administration seems pretty confident that HealthCare.gov can avoid punch-line status again when Obamacare enrollment reopens next month. Administration officials this week showed off improvements to the enrollment Web site that are supposed to be much more consumer-friendly — things like new smartphone capabilities, a shorter application process and the ability to actually use the "back" button while filling out the online application. As new Health and Human Services Secretary Sylvia Mathews Burwell talked with reporters Thursday about plans and expectations for Obamacare's second year, there are still some big question marks about the landscape for the health-care law when enrollment opens again Nov. 15.
How many will enroll this time?
It's about a month before open enrollment, but Burwell said the administration still hasn't set a sign-up goal for 2015. The Congressional Budget Office thinks 13 million will sign up through the marketplaces in 2015, but Burwell said the department is still analyzing how the first year of enrollment is playing out before it lays down a marker for 2015. It's a complicated exercise, she said, because the administration also needs to figure out how many of the 7.3 million current enrollees (by the most current count) will stick around for the second year. Some state-run marketplaces have set their own goals, though. California, which topped all states with 1.2 million enrollees in 2014, wants to sign up 1.7 million next year.
How's HealthCare.gov testing going?
Burwell said the enrollment Web site is being tested every day, with daily deadlines. We just won't know how that turns out until, apparently, the site reopens in November. As the Wall Street Journal reported this week, insurers involved in the testing have been banned from saying anything about it. A department official said the confidentiality rules are new this year because insurers had requested a longer testing period that is taking place before their plans are finalized. "This testing requires protection of security and market-sensitive information," the HHS official said. This will presumably keep testing results secret until after the midterm elections, which health insurance consultant Bob Laszewski thinks isn't just a coincidence.
How is the competition shaping up?
HHS reported two weeks ago that the number of insurers planning to sell on the marketplaces this year increased by 25 percent. More competition, in theory, should help keep down premiums, but it also matters how that competition shakes out at a very local level — and that's what HHS hasn't been able to say yet. Competition matters in a state like Georgia, for example, where a 21-year-old this year could face a $200 difference in average premiums for the same type of marketplace plan depending on where that person lived in the state. Of the five insurers who participated in Georgia's marketplace last year, just one sold statewide, so some high-cost parts of the state had far fewer plan choices. But four more insurers told the state they'll sell 2015 marketplace plans, including three that will sell statewide, so that suggests Georgians will benefit from more competition. The national picture, though, isn't as clear.
What do 2015 rates look like?
Final rates for all 2015 health plans, HHS says, won't be available until about a week before open enrollment starts Nov. 15 — which, again, will be after the midterm elections. The overall picture for 2015 rates appears to be good, compared to some of the dire predictions made earlier this year. Rates are projected to rise on average just 6 percent, according to PwC's Health Research Institute, which analyzed final and proposed rates in 38 states. But actual premiums will differ greatly across the country, even within a state.
What doctors can people see?
There's been some frustration this year about limited choice of doctors or difficulty determining what doctors are available in each plan. That might not get easier this coming year. That information still won't be available on HealthCare.gov in 2015, but insurers are supposed to provide that information on their Web sites. So, that means people are still going to have to do their homework if they want to keep their doctor. That's especially important as the administration will encourage current enrollees to shop around to get the best deal for them, as opposed to automatically enrolling in the same health plan. Getting accurate provider information can still be tricky though, since doctors can drop in and out of a plan's network during the course of a year. "It's an issue for the entire system," Burwell said. "It isn't simply a marketplace issue."