Connect for Health Colorado's chief executive expected to tally 40,000 health insurance enrollments during a deadline-driven surge of sign-ups.
Despite a rush of interest, the state's new health insurance marketplace appeared to remain well below its enrollment goals, hovering close to worst-case projections despite the midnight Monday deadline for coverage that's effective New Year's Day.
The totals garnered praise from some exchange board members - a nod to brightening metrics after a particularly weak turnout in October and November. But one board member said celebration might be "premature."
Enrollees must pay insurance carriers to activate their plans.
And now the question is: How many of those will actually have coverage Jan. 1?
"I just want to express caution until we get our first reconciliation report back," said Eric Grossman, who sits on the nonprofit's board.
Officials running the state's new health insurance marketplace say the onus falls on insurance carriers and shoppers to ensure the insurance plans they signed up for actually take effect in the new year.
A policyholder's first payment - called a premium - is typically due to an insurance carrier before coverage can start. Usually, that's Jan. 1.
This year, however, insurance companies agreed to extend the deadline for that first payment until Jan. 10 - meaning that Coloradans who purchased an exchange-based plan can wait until that date to pay and have their account in good standing, said Myung Kim, a marketplace spokeswoman.
People can seek health care during that 10-day grace period, but they will have to pay out of pocket for care and seek reimbursement once they have paid and received their insurance card, said Marc Reece, with the Colorado Association of Health Plans, an insurance carrier trade group.
"Since most enrollment happened between, really, Dec. 1 and now, it seems safe to say that there's probably a lot of people who haven't received an invoice yet," Reece said. "But then again, they're definitely on their way."
Monday's enrollment rush appeared largely confined to the marketplace's website and call center, which has faced progressively longer call wait times ahead of Monday's deadline.
A backlog of Medicaid applications was cleared over the weekend, said Susan Birch, the Colorado Department of Healthcare Policy and Financing's executive director.
With the backlog cleared, officials voiced optimism that insurance enrollments wouldn't be held up by delays in processing Medicaid applications - especially those submitted by Friday. Those applications are important because anyone seeking federal insurance subsidies needs to first be denied by Medicaid.
For those in the 36 states that are using the federal government's HealthCare.gov website to sign up for insurance, the Obama administration said enrollees will have a one-day grace period - effectively extending Monday's deadline by a day.
Colorado officials said they aren't extending the state deadline, but added they will do everything possible to get customers insured by Jan. 1.
Across the Pikes Peak region, sign-up assistance sites reported business as usual Monday.
Nineteen people wanting insurance sought help from Peak Vista Community Health Centers, while another 108 people visited Peak Vista seeking expanded Medicaid benefits, said Lois Vigil, Peak Vista's enrollment service and outreach manager.
Peak Vista - a massive nonprofit largely serving low-income families - saw the most people since the marketplace opened Oct. 1. Enrollment specialists there helped 841 sign up for insurance and assisted 4,369 get expanded Medicaid benefits.
A handful of people visited the assistance site at Tri-Lakes Cares in Monument.
The nonprofit is a food-stamp distribution site and traditionally aids low-income families. As a result, many of its clients will be eligible for Medicaid, which expanded under the Affordable Care Act to include people making less than 138 percent of the federal poverty level, or about $15,000 a year.
The lone insurance customers arrived shortly before 1 p.m. - a couple who originally wanted to cancel their insurance appointment. Expecting to pay about $1,000 a month for insurance, the couple asked to hold off enrollment because they couldn't afford to pay their first bill until about Jan. 20. The problem: That bill is due Jan. 10.
Diana Jansen replied by asking the couple to step into her office.
As a health coverage guide, Jansen has spent the past three months helping people navigate the website.
After 10 minutes of searching for federal subsidies, Jansen convinced the couple to come back and buy a plan.
Having factored in tax credits, their premiums cost closer to $70 a month, not $1,000.
"He was just going to skip a month (of coverage)..." Jansen said. "What's happened is that people really don't know how much it's going to cost."