ACA Enrollment Enters Its Last Week With Nearly 10 Million Enrolled

Sunday marked the beginning of the last week of open enrollment under the Affordable Care Act (ACA), and at last count 9.9 million individuals had signed up for Marketplace coverage, according to numbers from HHS.

A report released February 4, more than 10 million applications have been submitted through the federal Marketplace, which is being operated in 37 states.

Nearly 7.5 million individuals have selected plans or were automatically re-enrolled through HealthCare.gov. Another 2.4 million people selected plans through the 14 state-run Marketplaces, according to Bloomberg BNA.

“Time is running out,” HHS Secretary Sylvia M. Burwell said in a statement. She added that 87% of those who have signed up for coverage have qualified for financial assistance.

However, the Supreme Court could decide that federal subsidies that help lower the cost of premiums for low-income Americans on the federally run Marketplace are not legal. Such a decision would mean those 7.5 million individuals enrolled through HealthCare.gov could lose their financial assistance.

Next month, the Court will hear the case King v. Burwell which challenges these subsidies on the grounds that when Congress passed the healthcare law the language only specified making subsidies available for state-run Marketplaces.

A letter in the New England Journal of Medicine argued that eliminating the subsidies would make the health insurance marketplaces wildly unstable. They predict that if the Court rules with the plaintiffs, enrollees who cannot pay for premiums without the financial assistance could lose coverage within 30 days of failing to pay. Furthermore, those who do continue to pay and stay in the exchanges will likely be sicker than those who drop their coverage.

A RAND study estimated that without the subsidies for the federal Marketplace, enrollment could be reduced by 70% while premiums rise by 47%, or $1610, a year for a 40-year-old nonsmoker with a silver-level plan. Similarly, the Urban Institute projected premiums would increase by 35%.

The deadline to sign up for coverage through the ACA Marketplaces is February 15. The penalty for not signing up for coverage in 2015 is $325 or 2% of income, which ever is greater. People who sign up by the deadline will be covered starting March 1.