Despite Trump's attacks, Obamacare sign-ups dip only slightly

Despite the Trump administration's repeated attacks on Obamacare, millions of Americans opted to sign up for coverage...

Posted: Feb 8, 2018 6:25 AM
Updated: Feb 8, 2018 6:25 AM

Despite the Trump administration's repeated attacks on Obamacare, millions of Americans opted to sign up for coverage on the exchanges for 2018 anyway.

Some 11.8 million people selected plans on the federal and state-based exchanges, down 3.7% from last year, according to the National Academy for State Health Policy. The data, released Wednesday, provides the first look at sign-ups for 2018 nationwide.

Just over 8.7 million people signed up on the federal exchange, while a little over 3 million picked plans in the 11 states and District of Columbia, which run their own marketplaces.

Obamacare advocates had feared that sign-ups would plummet after the Trump administration cut the open enrollment period in half, slashed advertising by 90% and reduced support for enrollment assistance. Also, insurers hiked premiums for many plans amid the uncertainty in Washington, D.C. and President Trump's elimination of funding for Obamacare's cost-sharing subsidies. However, in a strange twist, richer federal premium subsidies actually made coverage more affordable for many people.

Related: 8 ways Trump hurt Obamacare in his first year

The modest dip in sign-ups shows the importance of the Affordable Care Act to consumers, advocates argue.

The academy's figures provide the initial evaluation of how enrollment fared in the state-based exchanges, which have more control over their outreach efforts and enrollment schedules. Several states extended their season into January, with California and New York allowing people to select plans until the end of the month.

Sign-ups fell 5.3% in the 34 states that leave enrollment entirely to the federal exchange, healthcare.gov. But it remained essentially flat in the 12 state-based marketplaces and in the five states that have their own exchanges, but outsource the enrollment process to healthcare.gov.

The Centers for Medicare and Medicaid Services is expected to release its comprehensive review of 2018's open enrollment period in coming weeks. Enrollment isn't final until consumers pay their first month's premium.

Related: Mike Pence's home state can now require Medicaid recipients to work

Several state exchange directors said Wednesday that their robust marketing and outreach efforts helped to keep sign-ups even or ahead of last year's. The standouts included Rhode Island, which saw a 12.1% increase, and Washington, which had 7.7% more people pick plans.

Only four states -- California, Idaho, Maryland and Vermont -- saw sign-ups slip.

Peter Lee, executive director of the Covered California exchange, said one reason why its numbers fell 2.3% is because it encouraged residents who don't qualify for premium subsidies to buy coverage off the exchange, where rates were cheaper for some plans. He highlighted that nearly 390,000 new consumers signed up for coverage, an increase of 5% over the prior year.

Related: Millions more Americans were uninsured in 2017

While the state exchange directors said Obamacare remained strong this year, they were concerned about Congress' elimination of the individual mandate starting in 2019. A central pillar of the health reform law, the mandate requires nearly all Americans to get coverage or pay a penalty.

"While we've seen remarkable stability in 2018, 2019 looks very troubling," Lee said, noting that premiums could rise by 30% in some states.

While Republicans in Congress have largely moved away from trying to repeal and replace Obamacare after their efforts failed last year, the Trump administration continues to chip away at the law. It is in the process of relaxing federal regulations to allow the sale of more insurance policies that don't adhere to Obamacare's mandates, for instance.

Indiana Coronavirus Cases

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Cases: 1097128

Reported Deaths: 17438
CountyCasesDeaths
Marion1437882222
Lake712531225
Allen65537867
Hamilton50147482
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Elkhart39461538
Vanderburgh34221495
Tippecanoe30237271
Johnson27179463
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Porter25014381
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Vigo18764308
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Delaware16425291
Howard16408311
Monroe16379217
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Bartholomew12686188
Warrick11995189
Wayne11879265
Floyd11869225
Grant11701235
Morgan10252188
Boone9675120
Noble9069121
Henry9002165
Marshall8907146
Dearborn881799
Dubois8710139
Shelby8054128
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Lawrence7922182
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Jackson743893
Gibson7002118
Montgomery6910123
Harrison685296
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Steuben654186
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Ohio Coronavirus Cases

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Cases: 1683472

Reported Deaths: 26483
CountyCasesDeaths
Franklin1766331826
Cuyahoga1641462636
Hamilton1122641528
Montgomery794721387
Summit702171199
Lucas618431017
Butler55878803
Stark525841170
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Delaware26682182
Trumbull26664611
Licking26200335
Medina25291351
Fairfield24173287
Greene24051369
Clark21653387
Portage20709280
Richland20587336
Wood19626246
Allen18542320
Miami17031348
Columbiana16502331
Muskingum16416206
Wayne15432304
Tuscarawas14086357
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Erie12423198
Ashtabula12314225
Scioto12235182
Pickaway12070151
Ross11487223
Hancock11256173
Geauga10666174
Lawrence10504171
Belmont10259231
Huron9588155
Jefferson9462225
Union939175
Sandusky9068166
Seneca8692156
Knox8618169
Washington8613156
Athens827396
Darke8270179
Ashland7840147
Auglaize7741115
Shelby7337132
Defiance7210114
Crawford7082150
Brown7052115
Fulton7016111
Logan6857108
Mercer681697
Guernsey680283
Highland6615117
Madison641389
Clinton6388106
Williams628798
Preble6171139
Putnam6089120
Jackson572396
Champaign568286
Perry558879
Coshocton5552103
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Morrow506464
Fayette483170
Hardin477899
Gallia462978
Pike459076
Van Wert454691
Adams4514109
Henry424976
Hocking401493
Holmes3939137
Wyandot367973
Carroll351578
Paulding319349
Meigs302457
Monroe231860
Noble216447
Morgan210138
Harrison205152
Vinton183937
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