They are the 10.5 million people eligible for Obamacare coverage who, two years since enrollment began, still haven't signed up through the insurance marketplaces created for Obamacare.
Experts agree that these will be the hardest people to convince to buy healthcare coverage. They've remained uninsured through two signup seasons, because they don't believe they can afford it, don't think they need it, or haven't heard about it.
But what surprised many this month is that the Obama administration not only agrees that reaching the uninsured is a big challenge, but that it expects to enroll barely more this year than it did last year. This would leave the number of marketplace enrollees at fewer than half those originally expected by the end of 2016.
There are 10.5 million Americans eligible for Obamacare coverage who still haven't signed up. (AP file) Health and Human Services Secretary Sylvia Mathews Burwell announced in mid-October that her goal is only 100,000 more paid enrollees than the agency achieved last year. In June, 9.9 million people had paid for Obamacare coverage; during this enrollment season, Burwell hopes for 10 million people to pick a plan and pay the premiums.
"We believe 10 million is a strong and realistic goal," Burwell said. "We've seen high levels of satisfaction with the marketplace and expect the vast majority of our current customers will re-enroll. And our target assumes that more than one out of every four of the eligible uninsured will select plans."
But that will still leave a significant number of people, at least 7 to 8 million, lacking insurance through their employer, qualifying for the Obamacare exchanges, and yet still uninsured when enrollment closes at the end of January.
Add to that the people who are eligible for Medicaid but haven't enrolled and those who would have been eligible for Medicaid had their states expanded the program, and there's unlikely to be a big reduction in the approximately 32 million people who still don't have coverage six years after Obama signed the reform bill into law.
The uninsured rate dropped from 16.2 percent to 12.1 percent from 2013 to 2014, and in August, the Centers for Disease Control and Prevention reported that it's below 10 percent for the first time in American history.
But the administration's modest enrollment projections underscore future challenges, and make it vulnerable to criticism from Republicans keen to point to shortcomings in law they've repeatedly tried to repeal.
"They got the low-hanging fruit already," said Tim Jost, health law professor at Washington and Lee University and a leading proponent of the law. "If you don't have universal coverage, how do you reach people, many of whom have very little money, very frantic lives, very little education? They're not people out there shopping the Internet for anything, much less insurance coverage."
Advocates of the law face the simple fact that for people on low incomes, health insurance is dauntingly expensive. The administration estimates that half of the uninsured have less than $100 in savings, and nearly eight in 10 have less than $1,000.
While the tax penalty for remaining uninsured increases for the 2015 tax year to $325 or 2 percent of adjusted income, it's doubtful that this will prove a big incentive to low-income people. Most will qualify for a hardship exemption; in fact, the Congressional Budget Office has estimated that all but 7 million of the remaining uninsured will be exempt from the fine.
Conclusion of the story at The Washington Examiner
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