ACA enrollment expected to fall well short of last year
Nearly 4.7 million people have signed up for health insurance through the Affordable Care Act (ACA) exchanges on Healthcare.gov. After a high volume of calls just before the deadline, the CMS asked callers to leave their information and said they would still be able to enroll, The Hill reported.
With the deadline on Friday, however, the total enrollment in ACA plans for 2018 is expected to fall well below the 9.2 million who signed up for plans through healthcare.gov during last year’s open enrollment.
This year's enrollees include about 1.4 million new customers. The other 3.3 million are staying with an ACA plan. The returning member number will increase since people with ACA plans who don't choose a plan for next year will automatically be renewed in the same plan or given a similar plan if their plan is no longer available.
The 4.7 million number includes only the 39 states that use healthcare.gov for their exchanges. The 11 other states run their own marketplaces. States with their own exchanges, such as Massachusetts, California and New York, all put their deadlines at the end of January. A total of 12.2 million people signed up for an ACA plan through healthcare.gov or a state exchange during the last open enrollment.
This year’s open enrollment started off strongly in the opening weeks and outpaced last year’s numbers. However, with this year’s shorter open enrollment period, weekly enrollment needed to double last year’s weekly totals to catch up.
Rep. Congressman Frank Pallone (D-N.J.), among others, has asked President Donald Trump's administration to extend open enrollment through January to give people more time to sign up. “Rather than actively suppressing enrollment, the administration should be making every effort to ensure Americans have access to healthcare,” Pallone said in a statement. “When the Trump administration decided to shorten the enrollment period this year, they knew it would lead to millions of Americans missing out on the opportunity to sign up for coverage.”
Also, in a letter to the acting secretary of HHS, Eric Hargan, and CMS Administrator Seema Verma earlier this week, Sens. Ron Wyden (D-Ore.) and Patty Murray (D-Wash.) wrote that ending open enrollment Friday may especially hurt consumers with pre-existing conditions. “This truncated enrollment window could force those with pre-existing conditions to decide between forgoing treatment and taking on crippling medical debt,” they wrote.
With a day left to sign up for coverage on https://t.co/ug816CzhZ6…— Dan Diamond (@ddiamond) December 14, 2017
- Hold times are over 40 minutes
- Shoppers waiting in line at deadline may not get to finish
- Democrats and some GOP are asking to extend sign-up period, but HHS has been silent
In addition to cutting the open enrollment in half this year, the administration slashed the program’s advertising budget by 90% and cut back on the navigator program that helps connect people with ACA plans.
With less advertising from the federal government, private payers have picked up the slack. Wesleyan University released new research that tracks TV advertising for ACA coverage. The researchers found insurers ran more ads during the start of the open enrollment and predicted that payers’ advertising may outpace last year’s combined ads from the federal government and private payers.
An added wrinkle this year is that Trump’s actions have actually resulted in more premium-free plans for 2018. Trump ended cost-sharing reduction (CSR) payments to insurers in the exchanges. The CSR payments help pay for out-of-pocket costs for lower-income Americans. However, by stopping those payments, Trump caused payers to increase premiums, which then kicked in higher federal subsidies that help lower-income people pay for premiums.
More than 80% of people in an ACA plan will qualify for tax credit, but those who don't will pay higher premiums in 2018, especially if CSRs remain unfunded and Congress repeals the ACA's individual mandate. Payers like stability, but they feel the exchanges have become unstable over the past year, especially with the current administration speaking out openly against the ACA.
Ken Wood, senior vice president of health plan development at Evolent Health, recently told Healthcare Dive, “Insurance markets work best when there’s stability and when everyone has a pretty good sense of how the market is going to operate. Sadly, we’re not there right now.”
- The New York Times Strong Demand for Health Insurance as Deadline Looms
- Healthcare Dive How will instability in the ACA exchanges affect healthcare in 2018?