Dive Brief:
- Enrollment in the Affordable Care Act exchanges dropped about 2.4% to 8.3 million from 8.5 million a year ago, according to preliminary figures from CMS.
- The agency described the number purchasing individual coverage at Healthcare.gov during the most recent open enrollment period that ended last week as “stable.” The data include a three-day extension granted after website issues gave some consumers trouble signing up.
- The data did not include enrollees who purchased coverage during the first three hours of Wednesday or consumers who left contact information at the call center for enrollment purposes. CMS said final enrollment data will be released early next month.
Dive Insight:
CMS attributed some of the decline to a few factors, including a strong economy that may have moved more people into job-based coverage.
Maine expanded Medicaid eligibility under the ACA, which the agency estimated would have shifted about 12,000 residents of that state away from purchasing exchange coverage. Nevada also opened a state-operated exchange, known as Nevada Health Link, for 2020 enrollment. CMS said about 84,000 Nevadans enrolled last year.
Since President Donald Trump assumed office in 2017, his administration has made numerous efforts to discourage enrollment on the exchanges, including shortening the enrollment period, virtually eliminating budgets for marketing and healthcare navigators, eliminating cost-sharing subsidies paid to insurers and signing into law legislation that zeroed out the financial penalty for not purchasing coverage.
Overall enrollment in both the federal and state exchanges dropped about 10% in 2017 and an additional 7% last year, according to CMS data.
Meanwhile, CMS Administrator Seema Verma kept up her inflammatory remarks about the ACA.
“Far from undermining the Affordable Care Act — as some hysterical and inaccurate claims would have it — the Trump administration is making the very best of what remains a failed experiment,” Verma said in a statement, seemingly contradicting her agency’s own position about the stability of the exchanges.
The ACA was dealt a blow last week when a federal court ruled the individual mandate was no longer constitutional without its financial penalty. That court did not rule, however, on whether that finding invalidates the law as a whole. That question will continue to play out in the courts and almost certainly put the law’s fate back at the U.S. Supreme Court sooner or later.