States say health sign-ups on exchanges increasing

• California says 15%2C000 enroll in insurance plans a day
• Deadline for coverage by Jan. 1 is Dec. 23
• People must have coverage by March 31 to avoid a penalty

WASHINGTON — States with their own well-running health insurance exchanges reported on Wednesday an increase of 30% to 40% in enrollments from last week to this week.

"We're seeing huge interest," said Peter Lee, director of California's exchange, during a conference call sponsored by Families USA, a health care advocacy group that supports the Affordable Care Act. Six months ago, "no American knew about" the state exchanges.

In the first week of December, 50,000 people signed up for insurance in California. Last week, 15,000 people were signing up every day, Lee said. He expects the interest to increase as local organizations, such as libraries or even cities, launch their own campaigns to encourage people to buy health insurance.

Lee and other officials in states that have expanded Medicaid coverage and spent millions promoting their exchanges said they are seeing an increasing diversity among the people buying insurance and the types they are purchasing.

The numbers show interest in buying insurance is increasing after the initial problems that hurt the site when it launched Oct. 1, said Ron Pollack, the founding executive director of Families USA. States that are doing well, he said, can share how they succeeded with other states and the federal government.

Not all state exchanges have been a success. Hawaii, Maryland and Oregon exchanges have been hampered by technology problems that have slowed enrollments in those states to a trickle.

People have until Dec. 23 to enroll in the exchanges, including HealthCare.gov, to receive health insurance coverage by Jan. 1. They must sign up by March 31 to avoid paying a fine at tax time for not having insurance. Most people who make less than 400% of the federal poverty level, or $94,200 a year for a family of four, are eligible for immediate subsidies to apply to their premiums.

More than half of Californians sign up start-to-finish in one day, Lee said. About two-thirds of people receiving subsidies are choosing silver plans, while most of the rest choose bronze plans. The plans are set up so people can compare benefits and costs of each insurer, and they're laid out as "metals" so people can quickly determine a benefit level. The levels, starting with the lowest, are bronze, silver, gold and platinum.

Lee said those choosing plans who aren't eligible for subsidies because they make too much money are buying all different levels of plans.

In Connecticut, Kevin Counihan, chief executive officer for Access Health CT, said 47,000 people have enrolled, and the site is seeing 1,400 enrollments a day. It also is receiving three times the number of phone calls as when the website launched.

"We didn't staff up fast enough," Counihan said, adding that staff has been doubled and will increase again for the March 31 deadline.

As of Wednesday, 23,410 people signed up for private plans in Connecticut, and 23,000 have signed up for Medicaid. About 47% of those in the private plans use subsidies, and 35% are people younger than 35, Counihan said.

In Kentucky, enrollments have increased 40% since Thanksgiving, said Carrie Banahan, executive director of the Kentucky Health Benefit Exchange. As of Wednesday, 92,000 people had enrolled, about 70,000 of whom signed up for Medicaid.

Twenty-nine percent of new enrollees in the private market are younger than 35, Banahan said. Forty-one percent of people are enrolling in silver plans, while 10% have enrolled in bronze plans and 2% have enrolled in catastrophic coverage.

In New York, enrollments increased 34% from last week to this week, said Lisa Sbrana, counsel for the New York State of Health.

"We continue to see a tremendous increase," she said.

As of Monday, 95,196 people had signed up for private insurance plans, and 39,426 had signed up for Medicaid. About 4,500 people a day are enrolling.

In Washington, Richard Onizuka, CEO of the Washington Health Benefit Exchange, said 20,000 people had enrolled through Nov. 30. He said they don't have new numbers because Washington's system was out the first week of December.

Still, 180,000 people have enrolled in Medicaid and an additional 55,000 have chosen a plan and just need to make their first payment. Of those who have enrolled, about one-fifth are not eligible for subsidies, Onizuka said. Eighteen percent were younger than 35. Fifty-nine percent of enrollees chose silver plans.

Washington just conducted a "brand awareness program" and found that 49% of those surveyed had heard of the Washington exchange — up 30 percentage points from mid-September, he said.

"The awareness of our radio and online ads had doubled," Onizuka said. "And about 70% of those who saw our ads have talked to an uninsured family member or friend about getting insurance."

Follow @KellySKennedy on Twitter