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Obamacare enrollment has 'lot of ground to cover'


Warding off the specter of election-year health insurance cancellations, the Obama administration on Wednesday announced a two-year extension for individual policies that don't meet requirements of the new health care law.

The decision helps defuse a political problem for Democrats in tough re-election battles this fall, especially for senators who in 2010 stood with President Obama and voted to pass his health care overhaul.

The extension was part of a major package of regulations that sets ground rules for 2015, the second year of government-subsidized health insurance markets under Obama's law — and the first year that larger employers will face a requirement to provide coverage.

Hundreds of pages of provisions affecting insurers, employers and consumers were issued by the Treasury Department and the Department of Health and Human Services. It will likely take days for lawyers and consultants to fully assess the implications.

The cancellation last fall of at least 4.7 million individual policies was one of the most damaging issues in the transition to a new insurance system under Obama's law. The wave of cancellations hit around the time that the new website was overwhelmed with technical problems that kept many consumers from signing up for coverage. It contradicted Obama's promise that you can keep your insurance plan if you like it.

The latest extension would be valid for policies issued up to Oct. 1, 2016. It builds on an earlier reprieve issued by the White House.

Penalty delay

The House on Wednesday backed a one-year delay in the penalty that individuals would have to pay for failing to sign up for health insurance, the 50th time Republicans have forced a vote to repeal, gut or change the law championed by President Obama.

The vote was 250-160, with 27 Democrats joining Republicans on legislation to postpone the individual mandate under the law. The measure stands no chance in the Democratic-led Senate and the White House has threatened a veto.

The vote was another example of the election-year political maneuvering on health care. Republicans remain convinced that public dissatisfaction with the law will cost Democrats in November's contests, helping the GOP increase its majority in the House and possibly win back the Senate.

— Associated Press

Wednesday, March 5, 2014, 10:39 p.m.

Students barely glanced at Beth Newman when she set up shop this week in the lobby of the Art Institute of Pittsburgh to promote the Affordable Care Act.

Newman, a federally funded navigator, is part of a last-minute push to get the uninsured to sign up for health insurance under the law. Open enrollment ends March 31 for anyone wanting coverage this year under President Obama's signature achievement.

“It's really tough,” said Newman, who in an hour at the Downtown school on Tuesday evening spoke to one person. Over a two-hour window earlier that day, she provided information to six people.

Her experience underscores challenges the law's advocates confront in persuading uninsured young adults to enroll for coverage.

The government is spending millions of dollars on TV commercials in markets with large numbers of uninsured, such as Pittsburgh, using social media such as Facebook and Twitter, and sending officials to sign-up events. The goal is to enroll 6 million Americans this year.

“We're heading to the finish line, and there's still a lot of ground to cover,” said Matt Eyles, executive vice president at Avalere Health, a Washington health care consulting company analyzing enrollment numbers.

Avalere Health estimated Pennsylvania needs to sign 354,000 people to provide its share of newly insured to meet the nationwide goal. By the end of January, 123,000 had signed up, according to the Obama administration.

Affordable Care Act Week

About 4 million Americans enrolled in plans through state and federal websites as of last week, the administration said. If a surge of signups materializes, the government could meet its goal, Eyles said.

Advocacy groups such as Enroll America, which operates in Pennsylvania and 10 other states, plan to announce on Thursday that they will hold an Affordable Care Act Week in Pittsburgh this month, backed by local politicians.

Pennsylvania has an estimated 1.2 million uninsured people and Allegheny County has the second-most in the state.

But just hitting the goal — scaled back from 7 million after the law's disastrous launch in October — won't be the only measure of its success. The law needs to reduce the number of uninsured, not just shift people into different coverage plans, and attract enough young, healthy people to make the economics work.

Those who enrolled need to pay their first monthly premium, the final step in securing coverage.

“The signup numbers are a good indication, but the picture is still a bit fuzzy,” said Larry Levitt, an expert on the Affordable Care Act for the Kaiser Family Foundation, a nonprofit, nonpartisan research organization in California.

He said it won't be clear until later this year how many enrollees are new to insurance, because millions of Americans last year had individual policies canceled.

‘Aggressive campaign'

The Centers for Medicare & Medicaid Services, an agency of the Department of Health and Human Services that is implementing the law, has intensified its work to “drive enrollment ... as part of a sustained, aggressive campaign,” spokesman Richard Olague said.

“Outreach is occurring in every state in the nation, with a particular emphasis on areas with the highest population of the uninsured,” he said.

The administration is targeting 19- to 34-year-olds in online and TV ads, spending $52 million on a nationwide campaign from January through March. ads featuring former NBA star Earvin “Magic” Johnson have run during sporting events on ESPN and during the Winter Olympics.

About a quarter of enrollees nationally are young people. A higher percentage would be better, Levitt said, but “there are enough young people to keep premiums stable.”

Homestead-based Allegheny Intermediate Unit, which employs Newman, scheduled more than a dozen events at colleges, libraries and community centers for March, including several at the Art Institute and Community College of Allegheny County.

Newman said it's difficult to find young people without insurance because many are covered by their parents' health plan. The law allows children up to age 26 to remain on their parents' plans.

Sign-ups may lag in Pennsylvania because many low-income workers fall into the so-called Medicaid gap. An estimated 500,000 to 600,000 Pennsylvanians won't get coverage this year because the state didn't expand its Medicaid program, as the law called for.

“It's heartbreaking. ... We plug in their numbers, and they don't qualify,” Newman said.

Despite the challenges, the government's outreach has picked up.

Roseanne Egan, a deputy regional administrator for the Centers for Medicare & Medicaid Services in Philadelphia, visited Pittsburgh for three days to meet with advocacy groups and attend signup events, including one that targeted young service workers at Franktuary, a Lawrenceville restaurant.

Enroll America added 40 people to its 300 trained volunteers in Pittsburgh, said Bill England, the group's state director. “I think we will be right there, or pretty darn close to hitting their target for enrollment,” he said.

Allegheny Intermediate Unit doubled its navigators to six and placed two in Beaver and Butler counties.

“Our call volume has definitely increased,” Newman said.

Alex Nixon is a Trib Total Media staff writer. Reach him at 412-320-7928 or

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