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U.S. sets 2016 PPACA goal at 10 million amid challenges

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(Bloomberg) — The Obama administration released a new Patient Protection and Affordable Care Act (PPACA) exchange qualified health plan (QHP) enrollment goal for 2016 that’s less than 1 million higher than this year’s projected total, acknowledging how hard it’s going to be to get more people to sign up for and maintain health insurance coverage.

By the end of 2016, about 10 million people will get individual coverage through the PPACA exchange system, the U.S. Department of Health and Human Services (HHS) projected Thursday. About 9.9 million people were enrolled in PPACA exchange plan policies as of June 30, and the administration has said that number will probably fall to about 9.1 million by the end of 2015 due to attrition.

“The remaining uninsured have a lot of concerns about whether or not they can afford coverage.” HHS Secretary Sylvia Mathews Burwell said Thursday on a conference call with reporters. She said most of those who remain uninsured are eligible for tax credits, though they’re often confused about the tax credits or unaware of them entirely. “We know our audiences are going to be harder to reach,” she said.

See also: How PPACA squeezes moderately high income 60-year-olds

Burwell said in September that many of the remaining uninsured are poorer and younger than those who’ve already signed up. Almost half are aged 18 to 34, and about 40 percent of them make incomes between 139 percent and 250 percent of the poverty level, according to data released Thursday by HHS.

Political issue

The affordability of health insurance has been brought up by both Republican and Democratic presidential candidates ahead of the 2016 election, and the administration’s success or failure in signing up people for coverage next year could heighten that debate.

Enrollment for 2016 coverage on the exchanges starts on Nov. 1, about three months before voters in each party begin choosing their candidates in Iowa, New Hampshire and South Carolina.

PPACA created online health care marketplaces as a way for millions of people to buy health insurance. Most of those who sign up on the exchanges get government subsidies to buy coverage.

The Congressional Budget Office (CBO) had projected higher enrollment totals for next year. In March, the CBO said 21 million people would gain coverage through the PPACA exchanges in 2016, and 24 million by 2017.

Burwell said Thursday that earlier projections for sign-ups had anticipated that more people would move to exchange coverage from employer plans, which hasn’t happened. People who have individual coverage outside the marketplaces also have been slower to move to PPACA policies.

Still, penalties for not having health insurance have been increasing, which may help push more people to enroll, officials on the call said.