- The Washington Times - Wednesday, November 21, 2018

Sign-ups on Obamacare’s main portal aren’t coming in as fast as they were last year, according to a federal “snapshot” Wednesday that looked at consumer interest three weeks into the 2019 enrollment period.

Roughly 1.9 million people have selected a health plan on Healthcare.gov, compared to about 2.3 million at this point a year ago — about a 17-percent drop, the Centers for Medicare and Medicaid Services said.

The new tally reflects one fewer day of sign-ups, which could explain some of the deficit.

The open enrollment season on Healthcare.gov, the federal exchange serving 39 states, began Nov. 1 and lasts until Dec. 15.

With just over three weeks left to enroll, “there is cause for concern,” said Timothy Jost, a law professor at Washington and Lee University who tracks the debate.

He gave multiple explanations for why early sign-ups are down. President Trump slashed funding for outreach and in-person enrollment assistance, expanded access to cheaper, bare-bones plans outside of the Obamacare exchanges and signed a Republican tax bill that gutted the “individual mandate” penalty for shirking insurance coverage.

The economy is improving, so more people might be getting insurance through a job instead of the exchanges.

Also, enrollment in Virginia is down by about 40 percent compared to last year. The state just expanded Medicaid coverage to people making slightly above the poverty level, so many newly eligible people will enter that program instead of the Obamacare exchange.

Unlike President Barack Obama’s team, the current administration doesn’t set an annual enrollment target, saying it is focused on managing a cost-effective sign-up season and making the process as smooth as possible for customers who use Healthcare.gov.

At this point, it’s not clear if the Obamacare program will catch up to last year’s total of 11.8 million sign-ups across the nation or if sign-ups continue a multiyear slide.

States that don’t use Healthcare.gov tend to give customers extra time to sign up on their Obamacare portals — until Jan. 31, in some places.

People who don’t actively renew their coverage will be automatically renewed, en masse, later this year, unless they opt out of coverage. A robust auto-enrollment number could help the program catch up to last year’s total when the dust settles on the final count.

There often is a deadline-day rush among people who log on and actively shop for a plan.

“It’s too soon to draw firm conclusions about what will happen to enrollment, since so many people wait until the last minute,” said Larry Levitt, senior vice president at the Kaiser Family Foundation. “But it would be a good guess at this point that sign-ups will drop somewhat.”

Though sign-ups have dropped in each the last few rounds, the program is not unraveling. Analysts say that’s because more than eight in 10 receive taxpayer-funded subsidies that help them afford their monthly premiums.

Average premiums on the exchanges are stabilizing in 2019 after years of sticker shock, with most places seeing mild rate increases or even decreases.

That’s good news for customers who earn too much for subsidies but still struggle to pay the full cost of their insurance. Rate increases have compounded over the years, however, so the positive trend might not be enough to bring a ton of new customers into the program.

Subsidized customers will find a mixed bag.

Last year, many customers received supersized subsidies after states decided to load premium increases — an outgrowth of President Trump’s tweaks to the law — onto silver plans that determine each customer’s level of federal help.

Yet this year, as silver “benchmark” premiums fall in many places, customers may see their subsidy shrink, too — even if their gold or bronze plan stays the same price.


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