President Donald Trump has frequently been accused of trying to undermine Obamacare, his predecessor’s signature health law. New data show that by at least one measure he didn’t do a particularly good job of it.
Enrollment in individual health-insurance plans under the Affordable Care Act fell 3.7 percent in 2018 to 11.8 million, from 12.2 million a year earlier, according to data compiled by the National Academy for State Health Policy, which calls itself a nonprofit, nonpartisan association of state health-policy makers.
That’s a far smaller drop than some health-policy watchers had foreseen, after the Trump administration halved the enrollment season and cut marketing and enrollment-assistance efforts. Trump himself declared the law “dead.”
The decline was concentrated in states where the federal government runs the Obamacare markets. In those 34 states, enrollment dropped 5.3 percent.
In states that handle their own systems and advertising, like New York, Colorado and California, sign-ups were essentially flat. States that run their own markets also typically offered longer sign-up periods.
Despite the smaller-than-expected decline, enrollment in the ACA’s exchanges has fallen from a peak of about 12.7 million in 2016, and the overall individual market has turned out to be smaller than estimated when the health law was passed.
One reason the numbers haven’t gone up may be that people are still getting coverage through their jobs in high numbers. When the health law was passed, policy experts predicted that some companies would quit offering coverage, sending workers to the Obamacare market.
Instead, companies continued offering insurance to their workers as a job benefit. A strengthening labor market may also have helped pull some people out of the ACA’s exchanges. More than 2 million more people were employed in January compared to a year earlier.
While premiums climbed, the overall effect on enrollment is unclear. On average, the sticker price of the cheapest plans rose 17 percent, according to the Kaiser Family Foundation. That likely drove some people too wealthy to get subsidies away from the market. But because subsidies rise alongside premiums, lower income consumers were insulated from the price hikes.
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