President Obama signs PPACA. (AP photo/J. Scott Applewhite)

(Bloomberg) — About 2.1 million people now have medical coverage through the Patient Protection and Affordable Care Act (PPACA) after a late surge in enrollment helped regain ground lost to the botched debut of the PPACA insurance exchanges.

More than 1.6 million Americans signed up through state and federal exchanges in December alone, according to calculations from data released yesterday by the U.S. Department of Health and Human Services (HHS). The December tally is more than quadruple the total from the first two months of the government’s sign-up period.

Open enrollment started Oct. 1.

Because payments for coverage starting Jan. 1 are not due until Jan. 10 or later, HHS is using whether consumers have picked plans, not whether they have started paying for coverage, as the benchmark for determining whether consumers have enrolled in private “qualified health plan” (QHP) coverage.

Officials said they don’t know how many of the 2.1 million people who have picked QHPs have already paid for coverage.

The Congressional Budget Office has predicted that the PPACA exchanges could provide private coverage for as many as 7 million people by the end of March.

“The new law is transformational for our entire health care system, and for millions of Americans who finally have health security,” HHS Secretary Kathleen Sebelius told reporters on a conference call.

In addition to helping 2.1 million people sign up for QHPs, the exchanges have helped 3.9 million people determine whether they were eligible for Medicaid and Children’s Health Insurance Program (CHIP) plans.

CVS Caremark
The government was prepared for newly insured people to begin seeking care at doctors’ offices, emergency rooms and pharmacies yesterday, and it has been coordinating with hospitals and insurers to smooth the process, Sebelius said.

CVS Caremark Inc. and Walgreen Co., the largest pharmacy chains in the nation, both said they would provide up to a month of prescription medications without any upfront cost for customers who can show they enrolled in an exchange plan, even if they don’t yet have an identification card or plan number.

People who experience trouble using their insurance at doctors’ offices, hospitals or other health-care settings should first call their insurer, Sebelius said.

If that doesn’t resolve the problem the government is putting 10,000 call center agents on duty to field questions about coverage from a toll-free number, 1-800-318-2596, Julie Bataille, a spokeswoman for the U.S. Centers for Medicare and Medicaid Services, said on the call.

Under Spotlight
Insurers, pharmacies and hospitals are used to handling patients’ changes in coverage from year to year, Phil Schiliro, a White House health-care adviser, said on the call.

“Usually there’s not a spotlight on what they’re doing,” he said. “Over the next few days, there will be.”

By 2016, about 34 million people are expected to gain coverage by private health plans sold through the law’s government-run marketplaces or by expanded Medicaid programs, according to the Congressional Budget Office. If those projections prove accurate, the sheer size of the PPACA’s constituency may secure its place in American society for decades to come.

For all its promise, the law’s future still remains uncertain. While PPACA survived a constitutional challenge before the Supreme Court in 2012, the law faces further court battles as well as a Republican-controlled House of Representatives that has voted more than 40 times to repeal or limit the statute.

–Editors: Romaine Bostick, Bruce Rule

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