According to numbers released by the Centers for Medicare & Medicaid Services today, nearly 12 million people signed up for health insurance under the Affordable Care Act, or Obamacare, during the 2018 open enrollment period. That number is a slight drop off from past enrollment periods, but supporters of the law consider it successful because of recent deep cuts to the program’s outreach and advertising budgets.
CMS’ final report on the 2018 period showed roughly 11.8 million people selected new plans or were automatically re-enrolled in Exchange plans in fifty states plus Washington, D.C. That includes 8.7 million individuals in thirty-nine states who use the federal, Healthcare.gov system, and about 3 million individuals who use State-based Exchanges.
CMS administrator Seema Verma touted the strong numbers while addressing the program’s overall shortcomings. “Our primary goal this year was to ensure that Americans who wanted coverage through the Exchange had a seamless experience. We are pleased that consumer satisfaction was the highest it’s ever been during the 2018 open enrollment period,” Verma said.
“However, even with the success of this year’s open enrollment, the individual market continues to see premiums rise and choices diminish. Average individual market premiums have more than doubled since 2013 compared to health plans on the Exchange in 2018, and half of U.S. counties have had only one issuer to choose from this year,” she added.
President Trump made repealing Obamacare a major campaign promise during his presidential run, but repeated attempts to repeal and replace the law fell short in Congress last year. The administration has instead taken steps to weaken the law with directives not requiring Congressional approval.
Several of those targeted the law’s budget for outreach and advertising, as well as funds for third-party groups that guide individuals through the enrollment process. Those budgets have been cut by 90%.
President Trump also announced last October, just weeks before the beginning of the open-enrollment for this coverage year, that his administration would stop reimbursing health insurance companies for cost-sharing reduction subsidies given to eligible individuals. Under the old CSR rules, individuals with incomes between 100% and 250% of the federal poverty line are eligible for plan-cost-reductions, such as reduced deductibles and co-payments.
A recent study by the Robert Wood Johnson Foundation, a healthcare education and advocacy group, has found that the elimination of those subsidies has helped increase the buying power of insurance consumers because it increased the level of related tax credit subsidies for eligible consumers.
The same study also found that Obamacare’s individual mandate, the elimination of which was included in major tax overhaul legislation signed by the President in December, was a positive for the insurance market and that repealing Obamacare’s essential health benefits may have long term adverse effects on markets, potentially turning the individual market into a “high-risk pool.”
The President has repeatedly said the failure of Obamacare will spur lawmakers on both sides of the aisle to compromise and come up with better solution for the country. “As I have always said, let ObamaCare fail and then come together and do a great healthcare plan. Stay tuned!” he tweeted last July after one failed repeal-and-replace attempt.