Under the Affordable Care Act (ACA), those who wanted coverage to begin by January 1, 2014 had to sign up by December 23, 2013. The deadline for signing up for health insurance and avoiding a tax penalty, however, is March 31, 2014. Social scientists and those who have studied similar government programs with a lengthy sign-up period say many people naturally procrastinate until a deadline looms. Washington Post economics reporter Ezra Klein notes that the ACA is similar to the Massachusetts health reforms and Medicare Part D—and that this experience shows that enrollment “begins as a trickle and spikes at the end.” Medicare Part D, which provides prescription drug coverage, began as a polarizing national law and also had a terrible rollout, he says. But today, more than 90% of seniors say they are happy with the program and consider it a success.
Optimists note that the number of people who chose insurance policies run by the federal government or the states, more than doubled between November and October. Skeptics, however, say those combined enrollment figures are still well below the administration’s March 2014 target of 7 million new enrollees. And they add that the law’s poor rollout has hurt its standing among millennials, who are generally healthy. Income from the premiums of young enrollees is essential to offset the cost of insuring more expensive, older adults.
Despite the current enrollment numbers, interest in the ACA appears to be growing rapidly. “The website, HealthCare.gov and phone center (1-800-318-2596) are fielding a large number of inquiries, which could be a positive indicator for future enrollment growth,” David Howard, a Professor of Health Policy at Emory University in Atlanta, told MedPage Today. According to the publication’s December 11 article, nearly two million more consumers have applied for and been told they are eligible for a plan.