Dive Brief:
- Approximately 8.8 million people signed up for 2018 coverage on HealthCare.gov during open enrollment CMS Administrator Seema Verma announced Thursday on Twitter.
- The number falls just a bit short of last year's 9.2 million signups, overcoming most predictions that 2018 enrollment would be drastically lower due to the enrollment period being cut in half, the program's a 90 % cut in advertising budget and cuts to outreach programs.
- Many state-run exchanges are still enrolling individuals, which could result in overall enrollment for 2018 to potentially exceed 2017, according to Larry Levitt, senior vice president at the Kaiser Family Foundation.
Dive Insight:
Despite the drastic cut in advertising funds from the federal government, insurers' efforts to run more ads may have made up some of the difference. Research from Wesleyan University showed that private payers TV advertising for the Affordable Care Act (ACA) may have outpaced last year's ads from both the federal government and private insurers.
President Donald Trump's decision to end cost-sharing reduction payments to insurers may have resulted in higher federal subsidies for lower-income individuals to pay for premiums. As a result, some insurers were able to provide certain plans to some people for what amounted to free health insurance.
I confess to being very surprised that ACA marketplace enrollment is down only slightly. That didn't seem possible with a 90% reduction in outreach, an enrollment period cut in half, and a constant refrain that the program is dead.
— Larry Levitt (@larry_levitt) December 21, 2017
Senate Finance Committee Ranking Ron Wyden (D-Ore.) and Senate HELP Committee Ranking Member Patty Murray (D-Wash.) recently wrote to HHS Acting Secretary Eric Hargan and Verma asking them to extend open enrollment. But it appears that the enrollment numbers were resilient despite what the two characterized as efforts by the administration to destabilize the insurance market.
CMS plugged the reduced spending on advertising, saying it spent only $10 million on marketing and outreach this year, compared to $100 million last year. 8,822,329 individuals signed up for insurance through HealthCare.gov between Nov. 1 and Dec. 15, with 2,394,107 signups coming from new consumers, according to CMS.
Charles Gaba, a highly respected ACA analyst, noted that the number of confirmed overall ACA exchange signups now stands at 11.62 million, with several signups remaining due to states exchanges with later deadlines and hurricane special enrollment periods. Gaba says that it is unlikely that the total signups will reach 12.2 million, last year's overall total, but predicts that 12 million could be feasible.
House Energy & Commerce Committee Ranking Member Frank Pallone (D-N.J.) praised the number of signups. "This is a remarkable result given the Administration’s efforts to sabotage enrollment by gutting outreach, creating chaos and confusion, cutting off subsidies for low-income families and shortening the enrollment period by six weeks," he said in a statement.
Senate Majority Leader Mitch McConnell (R-Ky.) told NPR Thursday that he plans to back off efforts to repeal further parts of the ACA in 2018, saying he wants the Senate to act in a more bipartisan manner. He added that unlike House Speaker Paul Ryan (R-Wis.), he does not plan to approach entitlement cuts without support from Democrats.