- The Centers for Medicare and Medicaid Services issued three new reports on the Affordable Care Act Monday, noting a 20% drop in enrollment during plan year 2017 among those not getting subsidies, and casting the data to make their case that federal and state exchanges and state individual health insurance markets are in turmoil.
- Subsidized enrollment, which makes up the vast majority of those enrolled in ACA plans, remained steady with a drop of only 3% during the same period.
- But critics noted the administration's repeated attempts to undermine the law, including repeal of the individual mandate penalty, pullback of exchange navigators and the expansion of association health plans and short-term, limited-duration insurance, to likely result in skimpier plans and the destabilization of the ACA marketplace.
The Trump administration and Republicans in Congress have made no secret of their opposition to the ACA, attempting and failing to repeal it completely last year.
The exchanges remain stable in 2018, but more people are relying on subsidies than the prior year, according to CMS. In February 2018, approximately 10.6 million enrollees gained coverage through the exchanges, with 87% relying on advance premium tax credits, compared to 10.3 million enrolled at the same time in 2017, with 84% using tax credits.
The agency said that rising premiums have increasingly raised costs to the federal government due to the law's subsidies.
“It is clear that many Americans are being priced out of the health insurance market, especially for employed people who earn too much to qualify for tax credits and have no access to employer-sponsored coverage,” CMS said. “This underscores the need for CMS to continue efforts to stabilize the market and provide all consumers—including those who do not qualify for large premium subsidies—with more affordable health coverage options.”
CMS Administrator Seema Verma say the new reports are evidence that the ACA is not serving the middle class and is leading to them dropping health insurance coverage.
“As the Trump Administration took office, there were warning signs that we were dealing with a crisis in the individual health insurance market and Obamacare was failing its consumers,” Verma said in a statement.
Protect Our Care, a liberal advocacy group, argued the Trump administration’s cuts to the advertising budget and navigator program amounted to sabotage of the last open enrollment.
“The Administration cut in half the number of days people could sign up for coverage; reduced the outreach budget by [90%]; and used funding to boost open enrollment to launch a propaganda campaign against the ACA. All told, these actions reduced enrollment by more than one million people,” Protect Our Care Executive Director Brad Woodhouse said in a statement.
But CMS said the actions simply shifted the burden of supporting enrollment to the private sector, noting that navigators “enrolled less than 1% of total enrollees.”
The agency also argued that its changes to the special enrollment periods improved risk pools, noting that the requirement for individuals to verify eligibility has cut the number of exceptional circumstance special enrollment periods by 56% in 2017.