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Final Obamacare enrollment figures lag under Trump

Healthcare
Sign-ups for health coverage under the Affordable Care Act dropped dramatically in the last two weeks of the enrollment period, according to new federal data.
(Getty Images)

Enrollment in Obamacare health plans sagged markedly after President Trump’s inauguration, according to new federal data that show sign-ups slowed in the final two weeks of the 2017 open enrollment period as Trump stepped up attacks on the healthcare law.

The slowdown is particularly noteworthy as enrollment was running slightly ahead of last year’s pace until Trump took office Jan. 20 amid renewed promises to scrap the 2010 Affordable Care Act.

Altogether this year, slightly more than 9.2 million people signed up for coverage in the 39 states that use the HealthCare.gov marketplace operated by the federal government.

That is down from more than 9.6 million who signed up last year.

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The enrollment tally — which doesn’t include sign-ups from 11 states, including California, that operate their own marketplaces — is still substantial, undercutting claims by Republicans that the healthcare law is collapsing.

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But the dramatic drop-off in the last two weeks fed rising criticism that the Trump administration is sabotaging the marketplaces to strengthen its political argument that the law must be scrapped.

“There is no doubt that enrollment would have been even higher if not for the uncertainty caused by political attacks on the law, and the Trump administration’s decision not to provide consumers with all of the resources and support available to help them enroll,” said Anne Filipic, president of Enroll America, which helps consumers sign up for coverage.

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Within days of taking office two weeks ago, the administration pulled television ads urging Americans to sign up for health insurance.

Trump also issued an executive order in which he suggested his administration wouldn’t implement rules crucial to sustaining markets.

And over the last two weeks, Trump and many GOP lawmakers have stepped up their criticism of the marketplaces, even as insurance industry officials warned that Republicans risked destabilizing the markets.

Only about 376,000 people selected a health plan through HealthCare.gov in the two weeks leading up to the Tuesday deadline, according to the recently released data.

By comparison, nearly 687,000 people chose plans through HealthCare.gov in the final one week of the open enrollment period last year.

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“They achieved what they wanted,” said Andy Slavitt, who oversaw the marketplaces as head of the Centers for Medicare and Medicaid Services in the Obama administration. “And 500,000 [people] are worse off for it.”

Total national enrollment, including sign-ups from state marketplaces, will be available in March, Trump administration officials said.

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Obama administration officials had aggressively urged Americans to continue signing up for health plans even as it prepared to hand over control of the marketplaces Jan. 20. 

And enrollment data suggested they were successful, as sign-ups appeared on track to surpass last year’s total.

About 11 million people got commercial health plans last year through HealthCare.gov and similar state-based insurance marketplaces created through the law.

More than 80% of these consumers receive government subsidies to offset the cost of their premiums.

There have been widespread concerns that the markets could collapse as insurers raised premiums sharply this year in the face of more costly than expected patients, and others left markets around the country.

Some Americans saw their monthly insurance bills rise by hundreds of dollars.

On Friday, Republicans continued to advance their clams that the collapse has started. 

“People may be enrolled, but that doesn’t mean Obamacare is working,” said House Energy and Commerce Committee Chairman Greg Walden (R-Ore.).

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But many industry officials, healthcare experts and consumer advocates, while urging changes to the marketplaces, have concluded that the GOP repeal effort represents the largest threat to the marketplaces.

Overall, the marketplaces and the expansion of state Medicaid programs for the poor — which were also made possible by the healthcare law — are credited with a historic expansion of insurance coverage over the last three years.

More than 20 million previously uninsured Americans have gained health insurance, data show, and the nation’s uninsured rate dropped to the lowest level ever recorded.

noam.levey@latimes.com

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