Facing new challenges to a legacy law, the Obama administration on Wednesday set its goals for the president's final health care sign-up season.
Health and Human Services Secretary Sylvia Burwell said she expects 13.8 million people to sign up, up 1.1 million from this year's number.
This is shaping up to be the most difficult sign-up season since HealthCare.gov launched in 2013 and the computer system froze up. But technology isn't the issue now. Premiums are going up sharply in many parts of the country, and some major insurers have exited the program, leaving consumers with fewer choices next year.
The administration says taxpayer-provided subsidies will cushion most of the impact of premium increases that are expected to be well into the double digits in many states.
For policyholders whose insurance company will no longer offer coverage, the government is automatically matching them with another carrier's plan. It's up to the consumer whether or not to accept the match or keep shopping.
Going into its fourth sign-up season, President Barack Obama's health care law has yet to achieve stability. Enrollment has been far lower than initially projected, insurers say patients turned out to be sicker than expected, and a complex internal system to help stabilize premiums did not work as intended.
The law offers subsidized private insurance to people who do not have coverage through their jobs, along with a state option to expand Medicaid for low-income people. Largely as a result of the Affordable Care Act, the nation's uninsured rate has dropped below 9 percent, a historically low level. More than 21 million people have gained coverage since the law passed in 2010.
The government said enrollment averaged more than 10 million people through the first half of 2016, and more than eight in 10 of those were receiving financial help.
Nonetheless, the law remains politically divisive and Republicans are still vowing to repeal it.
The administration is hoping for a strong sign-up season to validate the president's signature program, and for a victory by Democrat Hillary Clinton in the presidential election to close out the long-running political saga. Clinton has outlined steps she'd take to build enrollment and sweeten subsidies for consumers.
Sign-up season doesn't start until Nov. 1, but previously window shopping has been available about a week earlier on HealthCare.gov, now used by 39 states. That should be the case again.
Officials say returning customers will notice a smoother, more informative website, making it easier to compare plans. It's also been optimized for mobile devices. Those who are satisfied with their current plan don't need to do anything; they'll be automatically renewed.
Depending on availability, consumers will have a new option of picking "Simple Choice" plans. These are plans that have fixed deductibles and standard copayments, making it easier to compare them on premiums and provider networks. They'll display prominently on HealthCare.gov's plan comparison tool.
The administration is also planning a major outreach effort, including more than 10 million pieces of direct mail and a steady stream of email to an electronic mailing list of more than 20 million people. A top goal is to entice younger, healthier people to enroll. Expect pitches on social media platforms as well as television and radio.
This year, officials will emphasize the sticks — not just the carrots. Consumers will get reminded that going without health insurance risks a fine from the IRS, and the basic penalty is now $695.
Open enrollment ends Jan. 31. Consumers who want their coverage to take effect with the new year must act by Dec. 15.