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Challenges for Obamacare ahead of second open enrollment

The Obamacare open enrollment season begins in just two months. While HealthCare.gov is unlikely to melt down like last year, consumers still may face some complications.

Getting those who signed up this year enrolled again for 2015 won't be as easy as it might seem. And the law's interaction between insurance and taxes looks like a sure-fire formula for confusion.

For example:

- The roughly 8 million people who signed up for Obamacare this year are set up for automatic renewal, but those consumers risk sticker shock by missing out on lower-premium options. Additionally, if a consumer's income changed in the past year, they could get stuck with an outdated and possibly incorrect government subsidy. Automatic renewal should be a last resort, consumer advocates say.

- An additional 5 million people or so will be signing up for the first time on HealthCare.gov and state marketplace websites. But the Nov. 15-Feb. 15 open enrollment season will be half as long the 2013-2014 sign-up period.

- Of those enrolled this year, the overwhelming majority received tax credits to help pay their premiums. Because those subsidies are tied to income, those 6.7 million consumers will have to file new forms with their 2014 tax returns to prove they got the right amount. Too much subsidy and their tax refunds will be reduced. Too little, and the government owes them.

-Tens of millions of people who remained uninsured this year face tax penalties for the first time, unless they can secure an exemption. For 2014, the penalty is either 1 percent of income or $95 per adult plus $47.50 -- whichever is greater.

"It's the second open enrollment, but the first renewal and the first tax season where the requirements of the Affordable Care Act are in place," said Judy Solomon, vice president for health policy at the Center on Budget and Policy Priorities, which advocates for low-income people, and supports the law.

"The fact that it is all going to be occurring within an overlapping and relatively short time frame ... means that there will be many issues," she added.

Some congressional supporters of the law are worried about more political fallout, particularly because of the law's convoluted connections with the tax system.

"It seems to me there ought to be some way to better educate folks on what they may face in this process," Rep. Mike Thompson, D-California, told Internal Revenue Service Commissioner John Koskinen at a hearing last week.

Thompson wasn't impressed when Koskinen said the IRS has put information on its website and is using social media to get out the word.

Rep. Bill Pascrell, D-New Jersey, said in an interview that he disagrees with making people pay back part of their premium subsidy. That would happen if someone made more money during the year and failed to report it to HealthCare.gov.

"Why should individuals be punished if they got a bump in salary?" said Pascrell. "To me, this was not the ACA I voted on."

Last year, HealthCare.gov -- the website serving as the Obamacare portal for most states -- crashed as soon as it went live in October, and it slowed down the enrollment process significantly. This year, the Obama administration is promising a better consumer experience, but officials have released few details. It's unclear how well system tests are going.

"This coming year will be one of visible and continued improvement, but not perfection," said Andy Slavitt, a tech executive brought in by the Department of Health and Human Services to oversee the operation.

Alex Stevens, a dishwasher at an Austin pizzeria, got covered this year and said he's planning to re-enroll. A skateboarding enthusiast in his late 20s, Stevens broke a leg skating with friends this summer. It was a bad break and he had major surgery the next day. But his insurance paid most of the $55,000 bill, and he only owed $750.

"My mom said she was glad that I have insurance," said Stevens.

It's clear the health care law has filled a need for millions of people like Stevens -- in May, a survey showed that more than 8.9 million adults gained health coverage this year.

The second year will show whether the full program is workable for the people it was intended to serve, or if major retooling will be needed.

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