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Graphic designer Rayna Collins poses for a photo in her home in Lincoln, Neb., Friday, Dec. 11, 2015. Rising premiums and shaken faith among insurers have cast a cloud over sign-up season for President Barack Obama s health care law, and now it s crunch time again. Collins switched insurers for 2016 because the company she was with exited the market. Her premium will be just about the same, after subsidies the law provides for private coverage. But her deductible is going from $500 to $2,600.
Graphic designer Rayna Collins poses for a photo in her home in Lincoln, Neb., Friday, Dec. 11, 2015. Rising premiums and shaken faith among insurers have cast a cloud over sign-up season for President Barack Obama s health care law, and now it s crunch time again. Collins switched insurers for 2016 because the company she was with exited the market. Her premium will be just about the same, after subsidies the law provides for private coverage. But her deductible is going from $500 to $2,600.
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Getting your player ready...

WASHINGTON — It’s crunch time to sign up for coverage under President Barack Obama’s health care law.

The website works much better now, but rising premiums and shaken faith among insurers have cast new shadows.

Tuesday is the deadline for millions of uninsured procrastinators to sign up in time for coverage to begin Jan. 1.

As the health insurance expansion enters its third year, their decisions are critical to its economic viability. A surge of younger, healthier customers could hold down premiums in a market that’s struggling to grow.

“Medical costs of enrollees have been higher than expected, and total enrollment remains low,” said Caroline Pearson, a vice president at the consulting firm Avalere Health. “If participation is leveling off, then plans may be stuck with a risk pool that is not particularly balanced.”

More than half of the health law’s 23 nonprofit insurance cooperatives have folded, and even some major industry players have recently gone public with doubts.

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