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Drop in Late Obamacare Enrollment Appears to Be a Trump Effect Drop in Late Obamacare Enrollment Appears to Be a Trump Effect
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In the waning days of this year’s Affordable Care Act signup period, the Trump administration declared war on the health law, releasing an executive order that could weaken its requirements and yanking advertisements and outreach off the air. In the waning days of this year’s Affordable Care Act sign-up period, the Trump administration declared war on the health law, releasing an executive order that could weaken its requirements and yanking advertisements and outreach off the air.
Those actions appear to have made a difference. Signups for health plans in the states managed by the federal government are down slightly compared with last year. About 9.2 million Americans picked an Obamacare marketplace plan for this year, according to a government report released Friday. Last year, that number was 9.6 million. Those actions appear to have made a difference. Sign-ups for health plans in the states managed by the federal government are down slightly compared with last year. About 9.2 million Americans picked an Obamacare marketplace plan for this year, according to a government report released Friday. Last year, that number was 9.6 million.
The decline by itself isn’t that meaningful, but several snapshots over previous months had shown that signups were on track to overtake last year’s enrollment. It was only in the final two weeks of enrollment, when there’s typically a deadline-driven surge, that the numbers dropped. Fewer than 400,000 people signed up for Obamacare plans over the last two weeks. Last year, more than 700,000 people signed up in the last week alone. The decline by itself isn’t that meaningful, but several snapshots over previous months had shown that sign-ups were on track to overtake last year’s enrollment. It was only in the final two weeks of enrollment, when there’s typically a deadline-driven surge, that the numbers dropped. Fewer than 400,000 people signed up for Obamacare plans over the last two weeks. Last year, more than 700,000 people signed up in the last week alone.
The falloff suggests that Trump administration actions may have confused consumers, discouraged them from enrolling or simply made it easier to forget about the deadline.The falloff suggests that Trump administration actions may have confused consumers, discouraged them from enrolling or simply made it easier to forget about the deadline.
So far, the numbers do not show that the markets are failing, or in the “death spiral” that Mr. Trump and House Speaker Paul Ryan have often mentioned. But they show how important signaling is, and how confused the signaling currently is.So far, the numbers do not show that the markets are failing, or in the “death spiral” that Mr. Trump and House Speaker Paul Ryan have often mentioned. But they show how important signaling is, and how confused the signaling currently is.
Mr. Trump’s executive order, signed on the day of his inauguration, was widely reported as eliminating the law’s requirement to buy insurance. (I differ with that view.) And the reductions in outreach may have prevented some people who intended to sign up from getting the reminder that they needed. More broadly, promises from Mr. Trump and Republicans in Congress to quickly repeal Obamacare may have caused some people to think the law was no longer in effect at all.Mr. Trump’s executive order, signed on the day of his inauguration, was widely reported as eliminating the law’s requirement to buy insurance. (I differ with that view.) And the reductions in outreach may have prevented some people who intended to sign up from getting the reminder that they needed. More broadly, promises from Mr. Trump and Republicans in Congress to quickly repeal Obamacare may have caused some people to think the law was no longer in effect at all.
My colleagues Abby Goodnough and Robert Pear spoke with signup counselors around the country, who said many of their customers assumed that Obamacare would be repealed soon. My colleagues Abby Goodnough and Robert Pear spoke with sign-up counselors around the country, who said many of their customers assumed that Obamacare would be repealed soon.
Premiums were substantially higher this year than last in many places, and it’s possible that those high prices also depressed signups. But most Obamacare customers do not pay full price for their plans, so they do not feel the increases. Premiums were substantially higher this year than last in many places, and it’s possible that those high prices also depressed sign-ups. But most Obamacare customers do not pay full price for their plans, so they do not feel the increases.
Full national signup numbers won’t be released until next month. The 9.2 million signups reported Friday come only from states that use the federal government’s website to select plans. Signups appear to be up in a few states using their own system. Full national sign-up numbers won’t be released until next month. The 9.2 million sign-ups reported Friday come only from states that use the federal government’s website to select plans. Sign-ups appear to be up in a few states using their own system.
Of course, some people who signed up during the enrollment period may drop out of coverage or simply fail to pay their premiums, meaning the number of people who will be covered in Obamacare plans is likely to be lower than the current numbers. Moreover, people who signed up early for plans because they thought it was required may drop coverage if they come to believe they will face no penalty.Of course, some people who signed up during the enrollment period may drop out of coverage or simply fail to pay their premiums, meaning the number of people who will be covered in Obamacare plans is likely to be lower than the current numbers. Moreover, people who signed up early for plans because they thought it was required may drop coverage if they come to believe they will face no penalty.
That’s why the future health of Obamacare’s markets will depend largely on what the Trump administration and Congress do next. That path is hard to predict. After a week of steps that appeared to undermine the Obamacare markets, the Trump administration appeared to change course. Some of the canceled outreach was restored. And a new regulation, currently under review by the Office of Management and Budget, is expected to help stabilize the health insurance markets — though it’s hard to be sure until it is published.That’s why the future health of Obamacare’s markets will depend largely on what the Trump administration and Congress do next. That path is hard to predict. After a week of steps that appeared to undermine the Obamacare markets, the Trump administration appeared to change course. Some of the canceled outreach was restored. And a new regulation, currently under review by the Office of Management and Budget, is expected to help stabilize the health insurance markets — though it’s hard to be sure until it is published.
Yet on Friday, a spokesman for the Department of Health and Human Services — the agency still responsible for administering Obamacare — issued a statement that adopted the harshest tones of Mr. Trump. “Obamacare has failed the American people, with one broken promise after another,” said the spokesman, Matt Lloyd. “We look forward to providing relief to those who are being harmed by the status quo.”Yet on Friday, a spokesman for the Department of Health and Human Services — the agency still responsible for administering Obamacare — issued a statement that adopted the harshest tones of Mr. Trump. “Obamacare has failed the American people, with one broken promise after another,” said the spokesman, Matt Lloyd. “We look forward to providing relief to those who are being harmed by the status quo.”
A rapid Obamacare repeal is looking increasingly unlikely. Mr. Trump reaffirmed this morning that health care legislation is high on his priority list, but Congress’s efforts have largely stalled. The Trump administration may want to keep things calm in the interim. If so, it will probably take more steps to reassure anxious insurers and customers. Or it may decide that further chaos will help encourage congressional action.A rapid Obamacare repeal is looking increasingly unlikely. Mr. Trump reaffirmed this morning that health care legislation is high on his priority list, but Congress’s efforts have largely stalled. The Trump administration may want to keep things calm in the interim. If so, it will probably take more steps to reassure anxious insurers and customers. Or it may decide that further chaos will help encourage congressional action.
If Mr. Trump’s preference is the former, he may learn from this week’s news that his words matter.If Mr. Trump’s preference is the former, he may learn from this week’s news that his words matter.