Obamacare's signup deadline on Monday has its exceptions

By Susan Cornwell and Roberta Rampton

WASHINGTON (Reuters) - For most Americans who don't have health insurance, Monday is the deadline to sign up for coverage starting on January 1 under President Barack Obama's healthcare law.

For others, it's not a deadline.

There is a "hardship" exception for some that permits them not to sign up any kind of health insurance at all without facing a penalty - the hardship being problems they've encountered with Obamacare and its malfunctioning website HealthCare.gov.

There will also be a "good faith exception" for others, according to a senior Obama administration official.

"We'll have a special enrollment period," the official said last week, for "all those who make a good faith effort to get enrolled by the deadline" but fail to do so.

The official did not say how the government would determine whether or not the effort was made in good faith.

Still others may simply get a break from insurance companies, which the administration has urged to be flexible with people who miss the deadline.

Such is the uncertain state of "Obamacare" as it approaches what was originally supposed to be a defining moment - a signup deadline that would provide the first real test of the viability of the healthcare program brought into law by the Affordable Care Act.

Adding to the confusion is the fact that the original deadline for obtaining medical coverage was December 15. That was extended to December 23 after the federal government's website, HealthCare.gov, proved dysfunctional and sometimes non-functional.

The administration has reserved the right to change the deadline again "should exceptional circumstances pose barriers to consumers" enrolling on or before Monday.

Obama said on Friday that one million people had enrolled for new insurance plans under the law through HealthCare.gov, which serves 36 states, and 14 state-run marketplaces.

Many more enrollments are a major priority for Obama's signature healthcare reform, which officials are still hoping will help millions of uninsured and under-insured Americans finally to obtain medical coverage by the end of March.

GAPS IN COVERAGE?

It is not known how many consumers may have no insurance coverage during periods of 2014 because they failed to sign up on HealthCare.gov by Monday.

Some of the 14 states running their own healthcare exchanges have extended their sign-up deadlines past December 23.

On Thursday, the administration announced that if people's old insurance plans were canceled because of new standards under the law, they can claim a "hardship" exemption to the requirement that all Americans must have coverage by March 31 or face penalties that start at $95.

So some of these people may not sign up.

The Obama administration says it is trying to be flexible, but some Republican critics of the law say the frequent delays and changes have muddied the waters and confused people.

"With no clarity as to when people should sign up and who they should pay and when, it's a virtual certainty that many consumers will find themselves uncovered for a period of time through no fault of their own," Senator Orrin Hatch, a Utah Republican, said last week.

Administration officials said on Friday there are fewer than 500,000 people who have received cancellation notices from their insurance companies and have not yet found alternatives. Some were "auto-enrolled" in other plans by their insurance companies, the officials said.

The pace of sign-ups has picked up since October and November when technical problems crippled the HealthCare.gov website. Anyone who tried the website in October and November and became stuck has been getting attention from the administration.

Officials sent more than two million emails to people who could not advance through the website. They have also made more than 600,000 phone calls to consumers and mailed notices to hundreds of thousands of people, officials said.

"We are confident that we are doing everything we can so that individuals know what their options are to get coverage, whether it is at the marketplace or seeking it through the private insurers," said the senior official.

(Reporting By Susan Cornwell. Editing by Fred Barbash and Christopher Wilson)

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Obamacare's average monthly cost across U.S.: $328

By Caroline Humer

(Reuters) - Americans will pay an average premium of $328 monthly for a mid-tier health insurance plan when the Obamacare health exchanges open for enrollment next week, and most will qualify for government subsidies to lower that price, the Obama administration said on Wednesday.

The figure, based on data for approved insurance plans in 48 states, represents the broadest national estimate for how much Americans will pay for health coverage under President Barack Obama's healthcare reform law next year. The prices of the new plans are at the heart of a political debate over whether they will be affordable enough to attract millions of uninsured Americans.

Prices were lower in states with more competition among insurers and higher in states with fewer players, the U.S. Department of Health and Human Services (HHS) said in its report. Americans will be able to sign up for the new plans via online state exchanges beginning on October 1.

"For millions of Americans these new options will finally make health insurance work within their budgets," HHS Secretary Kathleen Sebelius said during a briefing with reporters.

The Obama administration is counting on signing up 7 million Americans in the first full year of reform through the state exchanges, including 2.7 million younger and healthier consumers who are needed to offset the costs of sicker members.

Debate over whether Obamacare will prove affordable for millions of uninsured Americans has been sharp during the past few months, as states have announced rates. States that have supported the law said it will lead to lower prices. Others that have opposed the reform - including Georgia, Florida, and Indiana - warned of "rate shock" for consumers compared to what they could buy on the individual insurance market a year ago.

HHS said the average price was 16 percent lower than its own projections on premiums. In addition, consumers who earn up to 400 percent of the federal poverty level, or $62,040 for a couple, will qualify for subsidies that will lower the price further.

TEXAS RATES BELOW AVERAGE

The data is mostly based on 36 states where the federal government will operate the insurance exchange. About 14 other states and the District of Columbia are running their own exchange.

Politics aside, states with the lowest average premium tend to have more insurance companies offering plans, the report said. It said eight issuers on average were selling plans in the states with average premiums in the lowest 25 percent, while states with average premiums in the top 25 percent had only three insurers on average.

Texas has been among the Republican-led states most fiercely opposed to Obamacare, but its monthly rates came in below the national average, HHS said. In Austin, Texas, with 76 plans to choose from, a 27-year-old would pay $169 per month for the lowest cost mid-tier plan. In Dallas-Fort Worth, with 43 plans to choose from, that price was $217 per month, the report said.

"The rates in Texas are looking good," said Gary Cohen, who is charged with overseeing the exchanges at the Centers for Medicare and Medicaid Services.

Enrolling enough consumers is key to making the healthcare overhaul work economically, with price considered the most important factor driving enrollment, according to insurance industry surveys.

Another concern has been that insurance companies will limit access to doctors in order to keep prices low. Cohen said that these so-called "narrow networks" were a trend before the Affordable Care Act went into effect.

The law was adopted in 2010 but two of its main pillars, the health exchanges and the expansion of Medicaid, take effect in 2014. Household names like UnitedHealth Group Inc, Aetna Inc, WellPoint Inc and Humana Inc will sell plans on at least some exchanges. Newcomers such as Medicaid specialist Molina Healthcare Inc will also play a role.

(Reporting by Caroline Humer in New York; Additional reporting by Lewis Krauskopf in New York; Editing by Michele Gershberg and Lisa Shumaker)

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