Obamacare sign-ups hit 365,000, but there's a long way to go

obamacare fall enrollment
More people are signing up for Obamacare.

Nearly 365,000 people have signed up for Obamacare in its first two months, but that's still a far cry from the 7 million projected to ultimately enroll for 2014.

The pace of sign-ups accelerated in November after the Obama administration worked to solve technical problems with healthcare.gov. Officials say there has been an even bigger increase in traffic in recent weeks.

Through November, just over 137,200 Americans have picked an insurance policy through healthcare.gov and nearly 227,500 through the 14 state-run exchanges, according to new federal figures released Wednesday. That's up from a total of 106,000 who signed up in October.

These figures reflect people who have selected an insurance plan, but not all have paid their first month's premium, which activates the coverage. An additional 1.94 million people have been determined eligible to enroll, but have not yet picked a policy.

Americans have until Dec. 23 to select a policy if they want coverage to start Jan. 1. They must start paying their premiums by the end of this year, or they may see their policy selection canceled. Open enrollment for those who want coverage in 2014 ends March 31.

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Federal officials said they think they are on track to reach their goals and noted that many people wait until the last minute to enroll.

"We're not exclusively focused on reaching a particular number. What we're focused on is reaching the millions of people who are really looking for affordable health care coverage," said Michael Hash, director of the Office of Health Reform in the Department of Health and Human Services.

Total enrollment is not the only important measure, Hash said. The viability of the exchanges depends on how many enrollees sign up in each state and the mix of participants.

"It's really about who signs up and where," he said.

Obamacare must attract younger, healthier people to offset the higher costs of the older and sicker. Otherwise, premiums could jump for 2015.

Aetna CFO on Obamacare exchange rollout
Aetna CFO on Obamacare exchange rollout

Only a handful of state exchanges have released demographic data of those picking plans. California, for instance, said that younger residents age 18 to 34 accounted for about 22.5% of the sign ups in October, just about the share they represent in the state population.

Sign-ups vary widely by state. More than 107,000 Californians have picked plans, while only 44 Oregonians have. Florida leads the way in the federal exchange, with nearly 18,000 people picking plans, while North Dakota has only 265 sign-ups.

Only about 41% of the total number eligible to enroll so far qualify for subsidies, less than half of initial projections.

Separately, just over 803,000 people have been determined eligible for Medicaid or Children's Health Insurance Program (CHIP). Only half of states and the District of Columbia have opted to expand this public health program.

While federal officials have addressed many of the technical issues that plagued consumers' ability to sign up for a plan, they continue to wrestle with transmitting accurate applications to insurers. Officials say they think 90% of transaction forms are accurate, but are still working with insurers to match applicants records.

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