Health-care sign-ups reach 4.2 million

WASHINGTON - With less than a month remaining in the first enrollment period, more than 4.2 million Americans have signed up for health insurance on marketplaces created by President Barack Obama’s health law, administration officials announced Tuesday.

The new enrollment report suggests the administration probably will fall short of the 7 million sign-ups it had hoped to get for 2014.

The new numbers on enrollment show that about 943,000 people signed up for private plans in February, fewer than the 1.1 million that signed up in January.

Administration officials expect a surge of enrollment this month as the deadline approaches, similar to the burst in December, when 1.8 million signed up before an end-of the-month deadline for coverage starting Jan. 1.

But the sign-up figures overstate actual enrollment, as many consumers have not paid their insurance bills. Administration officials have not released figures on the number of paid premiums. Some insurers have reported that as many as 1 in 5 consumers have not yet paid.

In Arkansas, enrollments through February reached 27,395. That was about 67 percent of the state’s goal of 40,800, according to the U.S. Department of Health and Human Services.

A report commissioned by the Arkansas Insurance Department in 2011 predicted 115,925 people in the state would enroll in 2014.

California continues to lead all states through the first five months of enrollment, with nearly 869,000 people signed up for a health plan through the state’s marketplace, Covered California. That was about 84 percent of the state’s goal.

Florida, which is among 36 states that are relying on the federal government to run their marketplaces this year, was second in the total number of sign-ups, with more than 440,000. But Florida had exceeded its goal of 381,600.

“Now, during this final month of open enrollment, our message to the American people is this,” Health and Human Services Secretary Kathleen Sebelius said. “You still have time to get covered, but you’ll want to sign up today.”

The state-based marketplaces - a centerpiece of the Patient Protection and Affordable Care Act - enable Americans who do not get coverage at work to select among plans that offer at least a basic set of benefits. The plans cannot turn away sick people.

Consumers who make less than four times the federal poverty level, or about $94,000 for a family of four, qualify for government subsidies to offset the cost of their premiums.

The administration said 83 percent, or more than 4 in 5, of the people signing up for coverage are qualifying for subsidies.

The share of Americans without insurance dropped in the first two months of 2014 to 15.9 percent, down from 17.1 percent in the last three months of 2013, according to a survey of 28,000 Americans by Gallup.

The survey’s authors noted that they cannot definitively conclude that the Affordable Care Act caused the change, but the decline started in the last three months of last year, just as the law took effect.

That followed a steady rise in the rate of uninsured beginning with the financial crisis late in 2008.

The increase in coverage was most pronounced among the group of Americans targeted by the new law: families and individuals with household incomes below $36,000 a year.

Consulting giant McKinsey Co., which has conducted four surveys of people who are eligible to sign up for insurance under the Affordable Care Act, found that 27 percent of those who signed up in February using the marketplaces were previously uninsured, up from 11 percent in its earlier surveys.

Many are older, with just27 percent of those who signed up in February in the coveted 18-34 age bracket, well below the 40 percent target administration officials have set.

Young, healthy consumers are considered crucial to the long-term sustainability of the insurance marketplaces because they help balance risk, keeping insurance premiums in check.

The administration is throwing resources into contacting young adults. Valerie Jarrett, a senior adviser to Obama, planned calls Tuesday to three radio programs aimed at young people and the White House hosted an event with entrepreneurs, researchers and graduate students that it called “#Geeks-GetCovered.”

Obama has made a special effort to appeal to young adults, including exchanging barbs with comedian Zach Galifianakis while pitching the health-care law on the actor’s parody Web talk-show Between Two Ferns. The appearance had drawn 3.9 million viewers by Tuesday afternoon.

Most experts believe that the youngest and healthiest consumers will wait until the last minute to sign up.

After March 31, open enrollment in private plans is closed for 2014 and people can only sign up if they experience life changes such as getting married or losing a job. Americans who don’t carry insurance starting April 1 will be liable for tax penalties of as much as 1 percent of their income.

The Congressional Budget Office said it expects the government to collect $2 billion in penalties next year.

Information for this article was contributed by Noam N. Levey of Tribune Washington Bureau; by Alex Wayne of Bloomberg News; by staff members of The Associated Press; and by Andy Davis of the Arkansas Democrat-Gazette.