As the third open enrollment season for health insurance under the Affordable Care Act comes to a close on Sunday, a new poll reveals that many uninsured Americans still aren’t paying attention.

The poll by the Kaiser Family Foundation, released Thursday, found that the majority of the uninsured say they don’t know the deadline for getting coverage this year. Virtually no one knew that the fine for going without health insurance in 2016 has jumped to $695 per adult or 2.5% of household income — whichever is higher.

One of the many factors that can cause a health insurance system to fail is “adverse selection,” a phenomenon in which those who know they will make higher-than-average claims are disproportionately likely to enroll and pay premiums. The inevitable results is a rapid increase in premiums, which encourages even more marginal consumers to forgo insurance, leaving average claims, and therefore premiums, to increase even further.

One approach to limit this problem is to limit the time frame during which enrollment is permitted. Why have limited open enrollment periods? The idea is that without them – that is, if anyone could enroll in health plans whenever they want – people could “game the system,” enrolling when they need health care, and disenrolling when they don’t.

Most uninsured Americans are sitting on the sidelines as sign-up season under the federal health law comes to a close, according to a new poll that signals the nation’s historic gains in coverage are slowing. The survey released Thursday by the Kaiser Family Foundation finds that:

– Only 15% of the uninsured know this year’s open enrollment deadline, which is Sunday.

– More than 7 in 10 say they have not tried to figure out if they qualify for the two main coverage expansions in the law, Medicaid and subsidized private health insurance.

– Only 1 in 100 know the minimum penalty for being uninsured is going up to $695 in 2016.

One reason why the anger over ObamaCare has subsided somewhat could be that more than 70 significant changes have been made to the law since it was enacted in 2010—delaying, weakening, and eliminating some of its more onerous and burdensome provisions. The law that is being implemented is not the one Congress passed.

By our updated count at the Galen Institute, at least 43 of the changes to the Affordable Care Act have been made unilaterally by the Obama administration, 24 have passed Congress and been signed into law by President Obama, and three were made by the Supreme Court, which had to rewrite the law to uphold it.

This is the second year that the Affordable Care Act and taxes will collide, and two changes this year could make the cumbersome tax filing process a bit more complicated.

Janna Herron of The Fiscal Times fills you in on what you should know this time around—the forms, the penalties, and the deadlines.

When the Affordable Care Act was drafted, the Congressional Budget Office expected people to sign up quickly for new health insurance.

Now, two years into the law, it’s clear that progress is going to be slower. The Obama administration acknowledged as much in late 2014, and again in October, when it presented its own modest predictions. Monday, the budget office also agreed, slashing its 2016 estimate by close to 40%.

In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them.

But these state officials should resist the temptation, for at least three reasons:

  1. First and most obvious is that expansion states have all experienced the same thing: More people signed up than expected, and it blew a hole in the states’ budgets.
  2. The second reason is that there’s no such thing as “free” federal dollars. The money comes with conditions, which effectively shifts policymaking from the receiving state’s legislature and governor to a distant federal bureaucracy (in this case, the Centers for Medicare & Medicaid Services), which dictates how states must spend federal Medicaid funds.
  3. The third reason is less abstract: Medicaid will harm those it’s meant to help. Often lost in the expansion debate is that Medicaid is the worst form of health coverage in the country.

The flurry of budget deals struck by congressional Republicans with President Obama in the final months of 2015 will increase the federal debt by hundreds of billions of dollars in the coming decade. They also make it clear that the true state of U.S. fiscal policy is far worse than shown in official projections — which are based on policies that are not going to survive over the long run.

James C. Capretta of the Ethics and Public Policy Center explains how the budget deals will affect the implementation of ObamaCare and ultimately the U.S. economy.

December’s omnibus budget package contained a measure to delay a provision of the Affordable Care Act by two years is giving finance chiefs some extra time to prepare.

The tax on high-cost employee health plans, or “Cadillac” tax, puts employers on the hook for a 40% levy on any excess cost of health plans above certain thresholds. Even before the delay, many companies and municipalities had already begun to assess whether their plans would trigger additional payments and make preemptive changes to avoid it.

The U.S. Treasury and Internal Revenue Service said they are extending some Affordable Care Act reporting deadlines to help companies meet the requirements. Employers will have two more months past Feb. 1 to give individuals forms for reporting on offers of health coverage and the coverage provided.

he deadlines to report this information to the IRS are extended by three months past the previous Feb. 29 due date for paper filings and the March 31 date for electronic returns, the Treasury said in a statement Monday.