Jayne O'Donnell, and Gregory Korte

USA TODAY

Federal health officials predicted Wednesday that nearly 14 million people will sign up for insurance on the Affordable Care Act exchanges for 2017, an increase of just over 1 million people from the last open enrollment.

This growth in sign ups is about the same percentage growth in health plan selections as last year.

President Obama will travel to Miami on Thursday in an effort to promote the exchanges during the open enrollment, specifically targeting young people whose lower health care costs help balance the risk pool for insurers.



White House Press Secretary Josh Earnest said those additional enrollments are important because the more consumers there are in state and federal exchanges, the more insurance companies will compete.



“And the more companies that are engaged in that business who are competing for that pool of customers, the more pressure we're going to put on prices to not increase it the same rate,” he said. “And we're also going to put pressure on those companies to improve their offerings.”

The new report from the Department of Health and Human Services also estimates monthly enrollment of people who have paid their premiums - known as effectuated enrollment - will average 11.4 million people over the course of 2017.

"It sounds like a prediction of basically 'business as usual' in the fourth open enrollment period – fairly high retention combined with a modest amount of new enrollment," said Katherine Hempstead, who heads the insurance team at the Robert Wood Johnson Foundation. "Given all the drama around price increases and (insurer) exits, that is a pretty upbeat projection and also probably a fair one."

The prediction, Hempstead said, "reflects the fact that most of the people in this market value their coverage a lot and are not fickle consumers."

HHS'.Office of the Assistant Secretary for Planning and Evaluation (ASPE) said the sign ups will come from people renewing their policies and from those signing up for the first time. There are about 10.7 million people who are uninsured and eligible for coverage through the state and federal exchanges.

The Kaiser Family Foundation said Wednesday that about 5 million of those currently uninsured could get financial assistance to buy their plans through the exchanges. HHS says about 2.5 million people who are buying plans off the exchanges would be eligible for subsidies if they bought on them.

Regulators approve higher health premiums to strengthen Obamacare insurers

Burwell told a gathering of people helping with ACA consumer outreach Wednesday that she feels "confident and excited" about the future of the exchanges, but acknowledged the challenges.

"Building a new market is never easy," Burwell said in the speech in Salem, Va. "We expect this to be a transition period for the marketplace."

Insurers, Burwell said, "are adjusting their prices, bringing them in line with actual data on costs."

Regulators approved rates that were actually higher than insurers requested in eight states, USA TODAY reported Tuesday. Charles Gaba of ACASignups.net, who did the rate analysis for USA TODAY, said this shows states are working to keep insurance companies from losing too much money.

Several large insurers have dropped off the exchanges citing large losses on the plans. HHS is working to attract younger, healthier people to offset the costs of insuring the sicker early enrollees.

HHS said about 85% of the uninsured have incomes that would make them eligible for financial assistance, while nearly 60% would also qualify for help with co payments and other cost sharing along with tax credits. Forty percent of the eligible uninsured are 18-34 years old.

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