Enrollment in the individual insurance market declined by 12 percent in the first quarter of 2018 compared to the same quarter in 2017, according to a new analysis released Tuesday.
The new report from the research firm Kaiser Family Foundation suggests that people without access to Obamacare subsidies are being priced out of the individual market for health insurance, a decline in enrollment that could play a major role in the 2018 midterm elections.
The analysis links the decline in individual market enrollment to premium hikes over the past several years on Obamacare’s insurance exchanges. Democrats have charged that actions taken by congressional Republicans and the Trump administration are fueling more price hikes.
The individual market, where people who don’t have insurance through a job or the government get insurance, houses Obamacare’s exchanges. While Obamacare exchange customers get premium subsidies to lower the cost of insurance, people on the individual market who buy insurance off the exchange do not.
In the first quarter of 2018, there were 14.4 million people who got coverage in the overall individual market, the foundation said. That total is 12 percent lower than the first quarter of 2017, when there were 15.2 million people on the individual market.
Of those 14.4 million people in the individual market this year, 10.6 million had coverage through Obamacare exchanges, including 9.2 million receiving federal premium subsidies, Kaiser said.
Enrollment is also below where it was in the first quarter of 2015, when 17.4 million people got coverage on and off the exchanges. Obamacare’s insurance exchanges went online in 2014.
“Much of this decline in overall individual market enrollment was concentrated in the off-exchange market, where enrollees are not eligible for federal premium subsidies and therefore were not cushioned form the significant premium increases in 2017 and 2018,” Kaiser said.
Overall Obamacare exchange enrollment, however, has held steady.
There were 10.6 million people on the exchanges in the first quarter of 2018, slightly above the 10.3 million people in the first quarter of 2017, the analysis found.
The enrollment analysis comes as premiums for Obamacare figure to play a major role in the 2018 elections.
Some states have proposed overall decreases to Obamacare rates, while others have called for double-digit rate hikes.
The states that are seeking rate hikes point to moves by the Trump administration and GOP-controlled Congress, including the repeal of Obamacare’s individual mandate financial penalty starting in 2019 as part of the tax law.
Critics also point to the Trump administration’s pursuit of cheaper plans that offer fewer benefits than Obamacare could also destabilize the exchanges. Critics worry that younger and healthier people will flee the law’s exchanges for the cheaper plans, creating further instability.
