About 12.2 million people signed up for or renewed their health insurance using federal and state marketplaces during the 2017 open enrollment period. The Centers for Medicare and Medicaid Services, which tallies the numbers each year and is responsible for administrating the federal exchange site, reported a 4 percent drop in sign-ups for this year. In 2016, about 12.7 million people signed up for health insurance using government marketplaces. The CMS report comes as rightwing lawmakers prepare for a battle to gain support for Trumpcare, the latest Republican-backed proposal to replace the Affordable Care Act.
Enrollment this year was on track to surpass enrollment for last year. Early during the season, numbers exceeded last year’s tally. It’s been suggested that President Trump’s decision to withdraw advertising funding for HealthCare.gov impacted the final number.
After taking office in January, Trump cut funding to the federal exchange’s marketing budget by $5 million, effectively stopping new advertisements in the final days of open enrollment. Last-minute plan elections are common during the annual signup period, but it appears that this year, enrollment dwindled in latter weeks. Cuts to advertising aren’t the only culprit. Concern over the future of healthcare reform has also contributed to hesitance in signing up for health insurance this year.
The Obama administration predicted that 13.8 million people would enroll in a health plan through federal or state exchanges for 2017. While enrollment was lower than expected, the numbers still indicate that people are looking for affordable, accessible healthcare options. Of the 12.2 million people who signed up, just over 3.8 million people – or 31 percent – were new customers. Most of the people who returned to the marketplaces did so actively, meaning that they revisited the site and signed up for another plan. Nearly 2.8 million people were automatically re-enrolled in plans from the previous year.
The majority of people who enrolled this year were younger than 54. Those aged 0-34 represented 36 percent of enrollees while people aged 35-54 accounted for about 37 percent of the total. Most enrollees chose silver-level plans, a popular choice since the Obamacare exchanges first opened. Silver plans cover about 70 percent of healthcare expenses. For people who qualify, silver plans also offer additional financial help to bring down premiums and offset out-of-pocket costs.
Cost assistance is one of the key concerns for consumers and lawmakers in Congress who are opposed to President Trump’s healthcare proposal. Under the American Health Care Act (Trumpcare), consumers who don’t qualify for job-based coverage or government-sponsored programs like Medicare would receive tax credits based on age rather than income. Young, healthy people will especially benefit from these age-based credits, leaving millions of people wondering if they would be able to afford coverage at all under Trumpcare. In 2017, about 83 percent of marketplace enrollees got subsidies to lower premiums.
Availability also remains a concern among consumers. According to the CMS report, just 18 percent of enrollees came from rural areas. The withdrawal from the marketplace of major insurers, including Aetna and United Healthcare, limited health plan choices for millions of people in 2017. Premium rates skyrocketed in many parts of the country. Most enrollees this year (71 percent) had incomes of 100 to 250 percent of the federal poverty line. Rural, low-income Americans will be particularly affected by any healthcare legislation that gets passed.
Trumpcare has been met with significant resistance from Democrats and moderate Republicans in Congress. As it’s written, the new bill is not a complete replacement plan for Obamacare since there’s only so much that Congress can accomplish through budget reconciliation. Still, the AHCA is a strong indicator of the direction that the Trump administration is headed.