Slightly fewer Americans have enrolled for insurance through the federal Obamacare marketplace compared to a year ago, the government said on Thursday, but the number was higher than expected in light of steps taken by President Donald Trump and Congress to undermine the 2010 law.
After a surge in the final days of enrollment, about 8.8 million new and returning customers signed up for 2018 health insurance policies from private insurers on the HealthCare.gov online marketplace, a decline of about 4 percent from the figures for 2017 policies, preliminary figures released by the Centers for Medicare & Medicaid Services (CMS) showed.
The truncated sign-up period closed on Dec. 15 on the HealthCare.gov system, which handles online enrollment in 39 of the 50 states. The remaining states run their own online enrollment and have deadlines as late as Jan. 31.
The HealthCare.gov deadline was extended to Dec. 31 in areas of seven states affected by storms, including Florida and Texas. In addition, CMS said it was still counting sign-ups from people who were placed in a queue in the last hours before the deadline due to high call volumes. That means the final tally potentially could show an increase over last year.
“It’s hard to view these numbers as anything but a success given all the headwinds this year, and a sign that the (Affordable Care Act) is not exactly dead,” said health economist Larry Levitt of the Kaiser Family Foundation research organization.
The enrollment numbers could play into the deeply politicized U.S. healthcare debate, with Democrats citing the relative stability as a sign that Obamacare remains a vital program to millions of Americans despite Trump’s insistence that it is “imploding” and already “dead.” Republicans may argue that their repeal efforts have not cut people off from insurance.
About 9.2 million people signed up for 2017 Obamacare policies through the federal website, with the total number including those who enrolled through state programs reaching about 12 million.
Evercore ISI analyst Michael Newshel said based on the new figures HealthCare.gov sign-ups appear to be on track to be relatively stable, a positive for health insurers like Centene Corp, Molina Healthcare Inc and Anthem Inc that sell plans under Obamacare.
Enrollment in states that run their own exchanges, accounting for about 25 percent of overall sign-ups, is tracking toward a “flattish” performance, Newshel wrote in a research note.
Trump and his fellow Republicans who control Congress failed this year to repeal and replace Obamacare, the signature legislative achievement of Trump’s Democratic predecessor Barack Obama, as promised. But they took a series of steps to weaken it.
A late surge
Even with the uncertainly surrounding Obamacare, a surge of people signed up at the last minute. CMS said 1.01 million new consumers and 3.13 million returning policyholders signed up from Dec. 10 to Dec. 15. In all, 2.39 million new consumers signed up for the program for 2018 policies, it said.
Private insurers sell strictly regulated individual insurance plans through the Obamacare online exchanges that the government subsidizes based on a person’s income.
Trump in October cut off billions of dollars in subsidy payments to insurers that help people pay for medical costs, causing insurers to raise 2018 premiums by more than 20 percent or drop out of selling plans in the Obamacare marketplace.
His administration also halved the enrollment period to six weeks and cut the federal advertising and outreach budget by 90 percent. It also has proposed putting cheaper insurance policies offering bare-bones medical coverage on the Obamacare market in 2019 or 2020.
The Republican tax overhaul passed by Congress on Wednesday revoked a key element of Obamacare: a fine imposed on people who do not obtain health insurance.
Health policy experts have said repealing that fine is likely to destabilize the Obamacare online marketplace by allowing the young and healthy to forego coverage, leaving people with costly pre-existing medical conditions and driving up premiums.
The nonpartisan Congressional Budget Office estimated that repealing the so-called individual mandate fine would increase the number of uninsured by 13 million by 2027. It also said premiums would rise 10 percent most years over the next decade.
Trump, who has systematically reversed a series of Obama’s policy achievements since taking office in January, said on Wednesday Obamacare had been essentially repealed with the rescinding of the individual mandate fine.
About 12 million people were enrolled at the beginning of 2017, a number that fell to the current figure of just over 10 million as individuals left the program during the year, a typical trend.
Brian Lobley, president of commercial and consumer markets at Independence Blue Cross in Pennsylvania, said this week that the company picked up its in-person outreach and online marketing to try to publicize the mid-month deadline.