CMS official numbers: Obamacare signups down, premiums (and subsidies) up
The decline is a victory for Obamacare supporters, who faced an uphill battle during and leading up to this year's enrollment period.
Obamacare appears to have weathered the first round of attacks from Congress and the Trump administration.
The final numbers reported by the Center for Medicare and Medicaid Services for open enrollment show that only 400,000 fewer people signed up for Affordable Care Act plans through federal or state insurance marketplaces. The total declined from 12.2 million last year to 11.8 million this year.
The decline is a victory for Obamacare supporters, who worried that the repeal of the individual mandate, the ending of cost-sharing reduction payments to insurers and the shortening of the enrollment period might lead to a dramatic decrease in marketplace participation.
There were pronounced differences in enrollment between states. Iowa, which experienced the largest average premium increase, saw a major enrollment drop. In the 11 states that run their own marketplaces, however, enrollment did not decline at all. The overall decline came exclusively from the 39 states whose exchanges are run through the federal marketplace.
Seema Verma, the head of CMS, described the figures as evidence of the “most cost-effective and successful open enrollment to date” in a tweet. She also criticized “skyrocketing premiums” and the “limited choice” in the health care marketplace.
The impact of the individual mandate repeal was most clearly displayed by the decline in enrollment among higher-income customers who aren’t eligible for premium subsidies.
However, 83 percent of ACA customers are eligible for subsidies, meaning that they don’t necessarily pay more out-of-pocket as a result of increased premiums. Instead, the government subsidy simply grows. On average, subsidies cover 86 percent of the premiums for subsidized customers.
In fact, a CMS report published on Tuesday found that subsidized customers are actually paying less per month than they were last year. On average, they are only paying $89 a month for their ACA plans. Last year, the average per-month cost was $106.
In contrast, those who don’t qualify for assistance are paying an average of $522 per month in premiums for Obamacare plans.