The number of people signing up for ObamaCare has surged in the first few weeks of open enrollment this year, contrary to dire predictions.
The spike in sign-ups is good news for supporters of the health-care law, but experts warn the early numbers don’t necessarily signify a trend. Final enrollment numbers could still be much lower than in the past, they say.
The first ObamaCare open enrollment period of the Trump administration has been surprisingly robust, despite the uncertainty caused by nearly 10 months of repeal attempts in Congress, rising premiums and insurer exits.
Through the first 18 days, nearly 2.3 million people have signed up for insurance coverage through ObamaCare exchanges, according to the Centers for Medicare and Medicaid Services, a number that has outpaced the same period under former President Barack Obama.
Larry Levitt, a health policy expert at the Kaiser Family Foundation, said enrollment is up significantly on a daily basis, but cautioned against drawing conclusions from the early numbers.
“But there are a lot fewer days” in the open enrollment period, he said. “It’s really hard to generalize from these early enrollment numbers.”
There are a number of factors that could weigh down enrollment this year.
Standard & Poor’s earlier this month forecast that enrollment could actually drop by as much as 1.6 million people below last year’s level of 12.2 million signups, in part due to uncertainty from the administration’s actions.
This year, open enrollment was cut in half and ends Dec. 15. Even if sign-ups stayed on pace, they would fall well short of previous years because of the shortened time period.
According to Levitt, much of the success of open enrollment also depends on how large the surge in sign-ups is as the deadline approaches.
Levitt said that in past years there were two surges: one around Dec. 15, when consumers could buy coverage effective Jan. 1; and one around Jan. 31, at the very end of open enrollment.
The deadline surge this year would need to be “quite large” in order to maintain steady enrollment from previous years, he added.
Many of the administration’s actions may also be spiking early enrollment, according to some health experts.
President Trump has claimed ObamaCare is “imploding” and with Republican lawmakers failing to pass a repeal bill, the administration has taken a hatchet to the law.
Trump signed an executive order that instructed agencies to loosen ObamaCare rules. He has also slashed advertising and outreach dollars by 90 percent.
The administration slashed funds by 41 percent for outside groups that help reach and enroll likely ObamaCare consumers. Last month, it cut off key subsidy payments to insurers used to bring down deductibles for low-income people.
Administration officials have pushed back on the idea that the cuts are part of an effort to sabotage the law, and on multiple occasions noted that ObamaCare enrollment was in decline before Trump took office.
It’s possible those actions have helped boost enrollment, at least in the short term.
“There could be a fear factor, people going out and enrolling before more changes happen,” said Katherine Hempstead, who directs coverage programs at the Robert Wood Johnson Foundation.
“The negative publicity has increased awareness a bit.”
Another reason experts are cautious of the numbers is because consumers may not be aware that many plans are cheaper than in the past.
Trump’s decision to cut off the insurance subsidies has created a situation where some consumers can get much cheaper plans than in the past. In almost every county, according to a recent study by Avalere Health, some consumers can even get a free plan.
Insurers have significantly raised their premiums as a result of losing the payments, but people who are eligible for tax subsidies under the law will largely be shielded from the spike.
“These free insurance plans for many low income people would be a huge selling point, if there were resources for outreach,” Levitt said. “Which there aren’t.”
The initial surge has also put the administration, which has long claimed the health law is failing, in a difficult spot.
The administration is issuing weekly updates about the number of people who enrolled in coverage using healthcare.gov.
But Trump officials are refusing to share what their enrollment targets are, a break in practice from the Obama administration.
If the final enrollment numbers are significantly lower than in the past, it could feed into the GOP narrative that ObamaCare is failing, and bolster new congressional repeal efforts.
There are high stakes for both sides in the ObamaCare fight.
Peter Lee, executive director of California’s insurance exchange Covered California, though, said raw numbers won’t tell the whole story.
“The issue isn’t how the administration talks about numbers, it’s how the administration promotes enrollment,” he said.
“I don’t care much about enrollment reporting. I care about enrollment promotion efforts.”
BY NATHANIEL WEIXEL – 11/23/17 12:05 PM EST