In the first few days of open enrollment under the Affordable Care Act, the numbers of participants has surged compared with the past, according to federal officials who spoke on the condition of anonymity because the administration has yet to release official numbers.
More than 200,000 Americans chose a plan on Nov. 1, the day open enrollment began, according to one administration official. That’s more than double the number of consumers who signed up on the first day of enrollment last year. More than 1 million people visited HeathCare.gov, the official federal website, the official said, which amounts to roughly a 33 percent increase in traffic compared with 2016.
These figures capture only a portion of the nation’s overall ACA enrollment, because they encompass states that either use the federal health care marketplace or rely on its website for their consumers to sign up for coverage. Roughly a dozen states and the District of Columbia run their own programs and do not use HealthCare.gov.
Several state exchange officials said Tuesday that the enrollment response they’ve seen over the past few days has exceeded their projections while running ahead of last year. States ranging from California to New York and Connecticut have all seen upticks.
An official at the Centers for Medicare and Medicaid Services who was not authorized to speak on the record said in an email that the agency was not releasing numbers at this time. “We plan to release enrollment snapshot data regularly throughout open enrollment as we have done in the past,” the official said.
Many advocates of the law were concerned that consumers wouldn’t sign up for coverage because Congress had tried to repeal it multiple times this year, and President Donald Trump had repeatedly described it as either “failing” or “virtually dead.”
Despite this criticism, and steep cuts to federal advertising and enrollment assistance budgets, Americans appear to be signing up for coverage at a faster rate compared to last year. It is unclear whether the extensive press coverage of efforts to roll back the 2010 law, or consumers’ concerns about its viability, may be helping fuel the increase.
Liz Hagan, associate director of policy at the National Association of Health Assisters, said in an email that she and other ACA supporters are “encouraged by what we’ve seen thus far. Thankfully, people sharing the facts about coverage and open enrollment have cut through the noise and rhetoric by the Trump administration.”
But Peter Lee, executive director of Covered California, said in an interview that many of the people who tend to sign up for coverage as enrollment starts tend to need insurance the most, and the critical question is how many young, healthy Americans will sign up some weeks from now. Federal enrollment this year lasts 45 days, half as long as it has in the past, while several states are allowing residents to sign up for ACA plans into January.
“The real test for open enrollment isn’t day one. Federally, it’s day forty-five,” Lee said. “Young, healthy people need to be reminded, told, nudged and cajoled dozens of times to take the act of signing up for coverage.”
Roughly 5,900 Californians selected plans last Wednesday, which marked a 25 percent over last year. In New York state, according to Department of Health spokeswoman Erin Silk, more than 140,000 people visited the state’s website and 73,000 placed calls to its customer service line “in just the first three days.”
“While is too early to report enrollment numbers,” Silk added, “we are seeing more consumers shopping and enrolling [in plans] compared to the same period last year.”
Connect for Health Colorado spokesman Luke Clarke said state officials had expected that 2,700 residents would call exchange operators on the first day, which would have been on par with 2016, but 3,406 did. “It’s way ahead of where we were last year, and a big surprise,” he said.
That same day in Connecticut, 1,596 residents enrolled in qualified health plans on the state exchange while another 2,293 people either completed Medicaid applications or determined that they were eligible for that program. Access Health CT CEO Jim Wadleigh said in a statement that the state’s call center and website experienced a 15 percent increase in volume compared to opening day last year.
MNsure Chief Executive Allison O’Toole said in a statement that enrollment there has been “brisk,” in part because the state received federal approval for a reinsurance program that means premiums will either stay level or decline for 2018.
“Last year, 40 percent of our enrollees were new, and we’re on pace to match that again,” O’Toole said.
Though this year’s enrollment process has gone relatively smoothly, Hagan said, “there are some places, particularly rural areas, where there is less assistance available for consumers wanting help, creating an unequal playing field that harms consumers.”
And while Lee expects many state-run exchanges, including his own, will maintain the same number of insured residents by the time open enrollment ends, he thinks states relying on the federal exchange will see a drop-off.
“We’re very likely to see fewer people enrolled in federal marketplace states, which is going to lead directly to higher premiums in 2019 because you’re going to have a sicker pool,” he said. “It’s bad math.”
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