HealthCare.gov Sees Early Rise in Enrollment Amid Worries on Law’s Future


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George Balteria, an insurance agent with California’s health care marketplace, explaining plans to Gene Yancosky this month in Huntington Beach.

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Nick Agro/The Orange County Register, via Associated Press

WASHINGTON — More than a million people have signed up for 2017 health insurance coverage on HealthCare.gov, and more than 300,000 of them selected plans in the three days after Donald J. Trump won the presidential election, the Obama administration said on Wednesday.

About one-fourth of those using the online exchange to sign up — 246,400 people — were new to the federal marketplace, and the other 761,800 were renewing coverage they had this year.

The data covered plan selections from Nov. 1, the first day of the fourth annual open enrollment period, to Nov. 12, for the 39 states that use the health care website. Federal officials said the total was 53,000 more than the number of selections in the first 12 days of the enrollment season last year.

Andrew M. Slavitt, the acting administrator of the federal Centers for Medicare and Medicaid Services, said he was pleased with the pace of plan selections. “It shows that health insurance is something people want and need,” he said.

Christen Linke Young, the deputy director of the agency that runs the federal marketplace, said the Obama administration was “moving forward” with planning for 2018. “It is business as usual with respect to how we are talking” to insurers, she said.

In the presidential campaign, Mr. Trump said repeatedly that Congress must “completely repeal Obamacare,” which he described as “an absolute disaster.”

But in the last week, he indicated that he would like to preserve certain popular features of the law, including ones that guarantee access to insurance for people with pre-existing conditions and that allow young adults to stay on their parents’ insurance until age 26.

Since Nov. 9, the day after Republicans secured control of the White House and both houses of Congress, the federal marketplace has received 8,000 telephone calls from people wanting to know how the election would affect their insurance coverage, Mr. Slavitt said.

He said the government had assured callers that “nothing is changing now and in the short term.” Republicans and Democrats disagree over the law, but “nobody wants to do something disruptive to consumers,” he said.

Mr. Slavitt’s agency is responsible for health programs that account for about one-fourth of all federal spending, but he said he had not had any contact with Mr. Trump’s transition team.

For the current open enrollment period, which runs through Jan. 31, the administration has declared a goal of having 13.8 million people sign up for coverage, an increase of 1.1 million over the last enrollment season.

Major insurers have pulled out of the marketplace in many parts of the country, and premiums for many of the remaining plans have shot up. But the Obama administration is trying to counter those trends with the message that federal subsidies will also increase, so that the consumer’s share of the premium will not rise much, especially if consumers are willing to switch to less costly plans.

One reason for rate increases next year is that the federal government has not paid insurers as much as they were expecting to receive to help offset financial losses under the Affordable Care Act.

The United States Court of Federal Claims recently rejected a lawsuit filed by an Illinois insurer, the Land of Lincoln Mutual Health Insurance Company, a nonprofit cooperative that had sought damages for the government’s failure. The ruling is ominous for insurers because many of them contend that they, too, were shortchanged, and a number have filed similar lawsuits.

At issue is a program intended to compensate insurers that lose substantial sums in the federal marketplace. Losses far exceeded expectations, and the Obama administration did not have enough money to make the promised “risk corridor” payments.

Judge Charles F. Lettow of the claims court said the government had neither a statutory nor a contractual obligation to pay the company more than it did — 12.6 percent of the amount Lincoln was expecting for 2014 and nothing for 2015.

The money was supposed to come from profitable insurers, but the government did not collect enough to pay the amounts owed to unprofitable insurers. The Affordable Care Act did not provide money to make up the difference, and “no valid contract exists” between the government and the Land of Lincoln insurance company, Judge Lettow said.

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