The Centers for Medicare and Medicaid Services reported Monday that total enrollment in Obamacare fell by roughly 300,000 people to 11.4 million for 2019, bucking predictions that millions of people would drop from the plans.
Monday’s numbers include data from the 11 states that, along with the District of Columbia, run their own exchanges, as well as previously released data from the federal government.
The Trump administration is calling the outcome “steady” compared to last year. The results defy projections from the nonpartisan Congressional Budget Office that said 3 million people who were on the exchanges would become uninsured if Republicans were to undo the law’s individual mandate, which imposed a fine on the uninsured. Republicans did zero out the fine beginning this year as part of the tax bill President Trump signed into law.
The small drop in people signing up for coverage occurred even though the Trump administration is allowing people to sign up for coverage outside Obamacare’s rules, and despite cuts in funding to advertising the law and to funding for “navigators” who help people enroll in coverage. Democrats throughout last year and during the enrollment period warned that millions of people would become uninsured and that the Trump administration was working to “sabotage” healthcare.
On average, health insurance in the Obamacare exchange for 2019 costs about $612 a month, though the federal government picks up the cost for most people who get coverage on the exchange. The average cost therefore was $87 a month to customers.
Millions of people, however, do not qualify for coverage and buy it outside the exchange. The income cutoff for subsidies is $48,560 a year for an individual and $100,400 for a family of four. Other factors at play in the cost include location, smoking status, and age.
The Centers for Medicare and Medicaid Services said the strong economy has contributed to the decrease in enrollment, noting that people who find jobs with coverage do not need to get health insurance from the exchanges. Also, roughly 100,000 people went from being on the exchange to being on Medicaid, the government health insurance program that covers low-income people at no cost to them.
Other factors likely limited the drop in coverage. Several states ran reinsurance programs, which inject federal funds that help pay for the sickest medical claims to keep down premiums for others on the exchanges. Also, people are automatically enrolled in plans if they don’t actively select them but were enrolled and paying premiums all year.
