Why Obamacare's March 31 enrollment deadline really can't budge

Other deadlines have slid, but the March 31 date for individuals to enroll in health coverage or face a penalty is the most important of all for Obamacare.

Luis M. Alvarez/AP
First lady Michelle Obama talks to Affordable Care Act enrollee Shownda Pagans, as enrolled ACA customer Allen Zullinger (l.), host Annie Neasman, and certified application counselor Myrlene Jackie (r.) watch, Wednesday, March 5, 2014, at the Jessie Trice Community Health Care Center in Miami, to highlight the work that hospitals, doctors, and clinics are doing to educate their patients about the Affordable Care Act and how patients can get insurance.

Obama administration officials are adamant that the fast-approaching March 31 deadline to enroll in health coverage will not budge. President Obama himself stressed the firm deadline at a town-hall event Thursday in Washington aimed at urging Latinos to enroll.

One could be excused for thinking that the individual-mandate deadline might be allowed to slip. The first two months of open enrollment were hobbled by the massive problems with HealthCare.gov and some of the state-run exchanges. And so many other aspects of the Affordable Care Act (ACA) have changed since the law went into effect, including two delays to the employer mandate to provide coverage. Several regulatory changes were just announced on Wednesday.

The biggest change was that the administration is now allowing people with plans that don’t meet ACA criteria to extend those plans to the end of 2016, if the insurers agree. That itself is the second such extension of so-called subpar plans, a remedy aimed at addressing Mr. Obama’s frequent false promise that “if you like your plan, you can keep your plan.”

But there are important reasons to stick to the March 31 deadline, health-care analysts say.

“If you’re the administration, and you want people to sign up by March 31, any indication that the deadline might be soft takes the pressure off for prospective enrollees,” says Larry Levitt, a senior vice president at the Kaiser Family Foundation.

Most Americans will face a penalty if they do not have health insurance in 2014: $95 or 1 percent of their income, whichever is greater. The law allows for three consecutive months without insurance in any calendar year. Thus, the March 31 deadline.

For insurers, having a limited enrollment period is crucial. Otherwise, healthy people could game the system by not buying insurance until they get sick. And after March 31, insurers face deadlines of their own to submit their premiums for 2015.

“The insurers have been concerned about the enrollment deadlines slipping and not having certainty about who they have signed up before setting premiums for next year,” Mr. Levitt says.

Still, Levitt sees a way the administration could allow for slight flexibility in the March 31 deadline. If there’s a massive surge in enrollments at the end of the month, and people cannot get onto the exchanges, then he could see a small extension in the deadline.

But even a small delay on that most important of the Obamacare deadlines could ignite an uproar. Already, one organization, the free-market-oriented Galen Institute, counts 37 changes to the ACA since the law was passed in 2010.

For now, the administration and legions of outside groups are doubling down on efforts to inform and enroll underinsured populations. Among Latinos, the rate of uninsured is 29 percent, compared with 15 percent of the overall US population. At the virtual town hall Thursday with Spanish-language media outlets at the Newseum, Obama addressed the frustration of some Latinos over deportations and his inability to pass comprehensive immigration reform.

"The main point that I have for everybody watching right now is, you don't punish me by not signing up for health care," he said. "You're punishing yourself or your family if in fact there's affordable health care to be had."

Only US citizens or legal residents are eligible to enroll in coverage via the exchanges and receive possible federal subsidies. Obama sought to allay concerns by saying that people who enter personal information onto a health exchange will not be risking the deportation of family members in the United States illegally.

With the clock ticking down to March 31, some 4,000 events are scheduled between now and then to educate consumers and encourage enrollment, according to the group Americans United for Change.

Lack of awareness continues to hinder enrollment. In February, among those uninsured between the ages of 18 and 64, only 24 percent knew that the deadline for enrollment is either March 31 or “the end of March,” according to the nonprofit Kaiser Family Foundation. Only 36 percent said they knew “a lot” or “some” about the health insurance exchanges.

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