WONDERS THE NYT. Turns out it’s expensive, there are better alternatives, people don’t like it, and it isn’t mandatory anymore.
More than halfway through the sign-up period for Obamacare health plans, fewer people have enrolled in coverage than during the same stretch last year. Enrollment through the federal website Healthcare.gov, which manages insurance marketplaces in 39 states, is down 11 percent compared to 2017, according to government figures released Thursday.
Given President Trump’s assault on the law, many people are watching this year’s enrollment closely for clues to its durability. While it is too soon to draw any firm conclusions, there are several reasons sign-ups could be lower — and not all of them spell trouble for the landmark legislation.
It’s important to remember that every year, there’s a surge in people who sign up at the last minute, right before the deadline, which is Dec. 15 this year. Moreover, customers can automatically renew their plans, and those renewals don’t get counted in the enrollment tally until later. Also, the latest sign-up numbers don’t include enrollments from 11 states and the District of Columbia that operate their own marketplaces. Those are reported separately and many of these states are reporting higher enrollment.
Still, several experts believe that the slow start in enrollment this year is likely to mean a smaller Obamacare market for 2019.
“Based on what we know now I would be shocked if enrollment was higher this year than last year,” said Josh Peck, a co-founder of the group Get America Covered and the former chief marketing officer for Healthcare.gov during the Obama administration.
The final numbers for the federal marketplace should come out before the end of the year. Here are some of the forces that may be influencing people’s decisions.
The mandate is gone
As part of its massive tax overhaul, Congress eliminated Obamacare’s individual mandate, the tax penalty for people who refused to get health insurance, beginning this year. That means people who were nudged into coverage by the threat of paying a fine may be sitting out this year.
But it’s hard to know how many people are dropping out because the penalty disappeared. Awareness of the change appears to be low, and enrollment is also down in New Jersey, one of the states that adopted its own individual mandate.
There are new options outside the ACA marketplace
The Trump administration also loosened restrictions about buying plans that don’t meet the standards set by Obamacare. Starting this enrollment season, people can buy coverage that is skimpier, but often much less expensive.
Rising premiums have priced some people who do not qualify for subsidies out of the Obamacare market, and there is some early evidence that more people who would have to pay full price for a plan are buying the so-called short-term plans instead. (But those plans aren’t available to people with pre-existing conditions.) Those shoppers tend not to be in the Obamacare market anyway.