Threatened repeal of Obamacare hovers over California health insurance sign-ups; deadline is Tuesday

Jan. 27--The two empty chairs at insurance agent Alberto Figueroa's desk Thursday may be an indicator of lingering uncertainty over the Affordable Care Act's future.

Heading into the final weekend for 2017 health insurance sign-ups in California and nationwide, agents like Figueroa are waiting.

"This year has been very slow. After the election, they stopped coming and the phone stopped ringing," said Figueroa, who's owned his Farmers Insurance office in a Franklin Boulevard strip mall for 14 years.

Business picked up a bit this week, following President Donald Trump's first day in office. "When the president didn't scratch the (Affordable Care Act) program, they started coming in again," Figueroa said.

Tuesday is the deadline for signing up for 2017 coverage. After Jan. 31, only those with changed circumstances -- losing a job, having a baby, moving within California -- can enroll in Covered California. Otherwise, consumers who don't have employer-based health insurance will need to wait until next fall, when there likely will be an entirely new health care system in place.

Although Trump and congressional Republicans have taken the first steps in their campaign promises to "repeal and replace" the Affordable Care Act, it's unclear exactly what the replacement health coverage program will look like.

Still, despite the ongoing debates in Washington, D.C., Covered California officials say the uncertainty hasn't deterred new sign-ups and re-enrollment by those with existing health coverage.

Roughly 1.3 million Californians have re-enrolled since Nov. 1, and more than 327,000 new people have signed up for 2017 coverage, a similar pace to last year's sign-up period, Covered California officials announced this week.

Speaking Thursday at a Covered California board meeting in Sacramento, Executive Director Peter Lee said the post-election environment has proved to be not as unsettling for consumers as anticipated.

In a research study, consumer beliefs that the Affordable Care Act would be canceled were "not associated with hesitation to enroll or renew," according to a Covered California study based on online surveys with 500 Californians and six in-person focus groups conducted by a Bay Area-based research group from mid-December to early January.

In most cases, Lee said, the biggest concerns are costs. Or as he put it during Thursday's meeting, "affordability, affordability, affordability."

"As much as consumers are watching what's happening in Washington, D.C., the issues before consumer are the issues of today. Can they put food on their table, pay their rent and afford health care coverage?" Lee said. "If they understand the subsidies, they're signing up."

Costs have been a contentious piece of the Affordable Care Act in recent years, as premium prices jumped in other states that don't have the same type of state-run marketplace as California. But even here, 2017 premiums went up by an average of 13.2 percent, partly due to a one-time loss of federal reimbursements to insurance companies. Lee has said that going forward, California's annual premium hikes would revert to single digits.

In recent weeks, about 50,000 consumers were affected by Covered California errors that led to higher-than-expected premiums or potential loss of their tax credits, according to Kaiser Health News. Officials have worked to correct the errors and have said that those consumers can still make changes before Tuesday's midnight deadline.

Another potential motivator for 2017 sign-ups could be federal tax penalties, which have increased annually for taxpayers who don't have mandatory health care coverage.

Insurance agent Figueroa, for instance, said some of his new enrollees this year are people who started their 2016 tax return and discovered the penalty they faced by not having health insurance.

This year, the 2016 tax penalty is $695 per adult (and $347.50 per child under 18) or 2.5 percent of household income, whichever is higher.

Figueroa's enrollment numbers are running far below previous years, he said. In 2015, he handled 400 new sign-ups and re-enrollments but has only had 50 new enrollees come in his door this time around.

Another veteran insurance agent, Frank Kwong, who runs a Cantonese-speaking State Farm office in south Sacramento, said he normally handles about 14 Covered California sign-ups a month. This year, that's dropped by half, to about seven.

"They're just worried. There's so much uncertainty," said Kwong, who said he was encouraged by Gov. Jerry Brown and other state officials who've vowed to retain the state's current health care coverage. "I want to reassure my clients and give them a positive note. But honestly, I don't know what will happen. It's affecting so many people."

Nationwide, as of Jan. 14, more than 8.8 million Americans had signed up for 2017 coverage through the federal HealthCare.gov site, according to the most recent federal report. That was slightly above the same period last year. Those numbers do not include the 12 state-run marketplaces, such as Covered California.

"Strong demand is especially striking in light of the unique headwinds created by discouraging rhetoric from (Affordable Care Act) opponents," said then-Secretary of Health and Human Services Sylvia Burrell, an Obama appointee who has since resigned. "More than 40,000 people have contacted our call center expressing concerns about whether they should sign up for coverage, with a sharp uptick in these questions last weekend."

With four days to go, more than 800 Covered California sign-up centers and hundreds of enrollment counselors are gearing up for last-minute sign-ups this weekend. For details on where and how to enroll, go to coveredca.com or call 800-300-1506.

In past years, during the final sign-up weekends, Figueroa said he stayed open both Saturday and Sunday, for people walking in to get last-minute help with enrollment. This year, he's not so sure.

"I'm gonna be sitting here Saturday ... but so far no one has called for an appointment."

Claudia Buck: 916-321-1968, @Claudia_Buck

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