Third sign-up period for Obamacare underway through Jan. 31

Obamacare’s marketplace opened its doors Sunday for the start of a three-month sign-up season that features a revamped HealthCare.gov and lingering questions about cost, competition and how to drive the remaining insured into the law’s insurance exchanges.

The administration wants to reach 10 million paying customers on the exchanges for 2016, a modest goal that’s slightly higher than its 9.1 million target for the end of 2015 — which it should meet — but less than half of what congressional scorekeepers estimated some time ago.

Officials at the Centers for Medicare and Medicaid Services (CMS) said the HealthCare.gov website serving 38 states was “up and running” at 7 a.m. Sunday, and that users submitted 40,000 applications for coverage in the first six hours.

By midday, the website was serving 25,000 simultaneous users, HealthCare.gov CEO Kevin Counihan said.

“The system’s stable. We haven’t had any bumps. So far we’re off to a good start,” he said at a kickoff event hosted by D.C.’s city-run exchange.

The exchanges are web-based markets where consumers can shop for private plans, often with the help of income-based subsidies. Besides HealthCare.gov, portals run by 12 states and D.C. also opened Sunday.

Rather than make a celebrity-laden splash for the Nov. 1-Jan. 31 enrollment period, the administration is using its advertising budget to focus on everyday consumers and affordability. Officials said returning customers should shop around instead of blindly re-upping in their existing plans.

According to the Health and Human Services Department, consumers who were willing to switch plans saved an average of nearly $400 last year, and that customers this year will find a sleeker, easier-to-use portal that lets users estimate their deductibles and other out-of-pocket costs.

Amid the cheery push, key challenges remain. Eleven out of Obamacare’s 23 insurance co-ops have failed, with Arizona’s pulling out Friday, prompting House Republicans to schedule two hearings this week on the program’s failures.

The co-ops, or Consumer Operated and Oriented Plans, were supposed to offer a consumer-oriented alternative to big-business insurance companies when the Affordable Care Act began to offer subsidized coverage on web-based marketplaces in January 2014.

Pundits warned they would have a hard time competing for market share, and government auditors found that to be the case in many states.

Also, consumers seeking 2016 coverage on the federal Obamacare exchange will see an average premium increase of 7.5 percent on the mid-tier, “benchmark” plans by which subsidies are calculated, the administration said in a preview of the enrollment season.

The rate hikes vary from state to state, from about 1 percent in Michigan to more than 30 percent in Alaska, Montana and Oklahoma, while benchmark premiums decreased in four states that use HealthCare.gov.

While notably higher than a 2-percent increase heading into the 2015 signup season, the administration can tout some progress compared to double-digit increases recorded in the years before Congress passed the health care law in 2010.

“The expectation was for slightly higher rates of premium growth compared to last year as insurers gained more information about the exchange population,” said Elizabeth Carpenter, a vice president at Avalere Health, a D.C.-based consultancy. “This is consistent with that forecast.”

But she said “geographic variation is significant, so we should use caution before reading too much into national averages.”

The administration also faces an uphill battle in rooting out customers who haven’t signed up already.

“We know that this year is going to be a little more challenging than years in the past,” HHS Secretary Sylvia Mathews Burwell said at the D.C. event. “With our historic gains in coverage and an improving economy, there are fewer uninsured to enroll.”HHS is targeting five key areas — Dallas, Houston, northern New Jersey, Chicago, and Miami — because they contain the largest concentrations of those eligible for coverage, and a rising penalty for lacking insurance could drive people into the marketplace.

Under the law’s “individual mandate,” people who stay uncovered in 2016 must pay a tax of $695 or 2.5 percent of their income above the filing threshold, up for $325 or 2 percent of income in 2015.