Enrollment in Obamacare’s exchanges dropped by 3.7 percent in 2018 compared to last year, an independent health group reported Wednesday, saying the program displayed “remarkable stability” in an uncertain climate, despite the decline.
The National Academy for State Health Policy said all told, nearly 11.8 million people selected coverage on either the federal HealthCare.gov website or state-run exchanges that finished up enrollment this past week.
That’s down from over 12.2 million in the 2017 season, meaning the program isn’t attracting the influx of enrollees it needs to improve its economic outlook.
Yet some analysts say it’s a net win after President Trump attacked the law, slashed outreach and tweaked some of its financial levers.
“For the first time we now have the full national picture of how the individual marketplaces did this year and it is a picture of remarkable stability,” said NASHP Executive Director Trish Riley. “Despite all the uncertainty and challenges we have seen, particularly for consumers living in states supported by state-based marketplaces, we see millions of Americans continuing to benefit from the coverage they get in the individual market.”
Wednesday’s report is not the official, governmental one that’s typically used to measure the health of the Affordable Care Act’s signature exchanges.
The Centers for Medicare and Medicaid Services said it cannot confirm the academy’s data. It will put its own, detailed report in March after it has validated data from state-run exchanges.
The academy — a nonpartisan group of state health policymakers — decided to crunch the numbers right away because enrollment is now closed in every state.
Based on its figures, the 11 states — plus D.C. — that ran their own exchanges matched last year’s sign-ups.
In fact, there was a tiny increase of 0.09 percent, compared to a 5.3-percent drop among the 34 states that solely relied on HealthCare.gov.
Five states that run their own exchanges, yet use the federal website, also saw a minuscule increase of 0.2 percent, according to the academy.
Mr. Trump slashed the enrollment season in half this year, meaning consumers in HealthCare.gov states had to sign up by mid-December, though hurricane-battered areas got extra time.
Interest in the exchanges outpaced last year on a day-to-day basis.
Analysts and state officials said that was partly due to super-sized subsidies created by Mr. Trump’s decision to cut off a separate stream of taxpayer payments to insurers, after congressional efforts to repeal and replace the entire law failed.
The administration took a victory lap last year, saying it operated the Obamacare system smoothly and efficiently, while spending outreach dollars more wisely.
Obamacare’s defenders, however, saw a sinister plot to “sabotage” the law. They’d wanted Mr. Trump to extend federal enrollment, noting states that offered more time tended to fare better.
“Strong enrollment in state based marketplaces underscores just how much higher enrollment in HealthCare.gov states would have been this year if not for the Trump administration’s actions,” Joshua Peck, who promoted the health law under President Obama, wrote on Medium.com.