Obamacare enrollment fell slightly this year, with 11.8 million consumers signing up for coverage compared with 12.2 million in 2017, according to an official count from the Trump administration.
Centers for Medicare and Medicaid Services Administrator Seema Verma tweeted the 2018 open enrollment, saying it was the “most cost-effective and successful” open enrollment to date. The Trump administration slashed outreach funding and halted insurer payments in the run-up to the 2018 open enrollment period late last year.
“Despite delivering the most successful consumer experience to date, Americans continue to experience skyrocketing premiums and limited choice on healthcare.gov,” Verma tweeted Tuesday.
11.8 million consumers enrolled for 2018 Exchange coverage nationwide. Great job @CMSGov on the most cost-effective and successful open enrollment to date!
— Administrator Seema Verma (@SeemaCMS) April 3, 2018
Part of the reason for the soaring premiums is President Trump’s decision in October to halt cost-sharing reduction payments to insurers, which prompted them to raise rates. The payments reimburse insurers for a requirement to lower out-of-pocket costs for low-income Obamacare enrollees on the exchange.
The 11.8 million figure, 3 percent less than last year, is the same as an unofficial count from the Associated Press released in February. In 2017, 12.2 million signed up for Obamacare coverage. The Obama administration presided over much of the open enrollment period for 2017.
The 2018 sign-ups came despite the Trump administration drastically cutting outreach funding from $100 million for the 2017 open enrollment to $10 million.
The Trump administration said that since Obamacare was in its fifth year, more money for ad funding was not needed. However, critics charged that the move, with the CSR payment cutoff, was part of a larger effort to sabotage the law.
Some states picked up the slack. California spent $110 million on advertising for the 2018 open enrollment but sign-ups on its state-run exchange fell by 2.3 percent.
Verma pointed to data that showed the risk pool of healthcare.gov signups grew slightly older this year. The share of individuals 55 and older that signed up for healthcare.gov, which is used by residents in 39 states to pick Obamacare plans, increased from 27 percent last year to 29 percent.
An insurance risk pool requires a good mix of younger individuals to supplement the older and sicker individuals in the pool.
Verma added that 83 percent of consumers nationwide got tax credits.
The share of consumers getting bronze plans, the cheapest of Obamacare’s three metal tiers, is up six percentage points for 2018 compared to the 2017 open enrollment. Meanwhile, the number of people getting silver plans, which were the most popular and the second metal tier, are down by nine percentage points.
This is likely a result of a majority of states using a tool called “silver loading” to offset the loss of CSR payments. The state directed insurers to put the entire cost of the CSRs onto the second-cheapest silver plan.
That plan is the benchmark that the Trump administration uses to determine the amount of income-based tax credits. If the second-cheapest silver plan rises in cost then so does the tax credits.
Some enrollees were able to use the boosted tax credits to completely offset the cost of getting a bronze plan, hence the rise in popularity.
Verma added in another tweet that the “data suggest that more affordable healthcare options are needed — especially for those forgotten women and men who are not eligible to have their premiums reduced by tax credits.”
The comments come as the Trump administration is proposing several regulations to expand access to cheaper but low-quality insurance plans. The administration wants to expand access to association health plans that are used by small employers and individuals. It also seeks to expand the duration of short-term plans from 90 days to nearly 12 months.
Patient advocates charge that while the plans could be cheaper, they offer skimpier “junk” insurance. The plans could also destabilize Obamacare’s exchanges because younger and healthier people would flock to the cheaper insurance plans, leaving the insurance pool on the exchanges much worse.
