Customers Defy Trump Attacks to Buy Obamacare, and Vote for ItBy and
Initial enrollment in ACA plans up 45 percent versus last year
‘Awareness of the program has never been higher’: consultant
President Donald Trump and Republican leaders in Congress have repeatedly said Obamacare is failing, or even dead. Yet there are signs across the country that support for the law’s programs is stronger than opponents have portrayed.
This week in Virginia, where Democrats won a competitive governors race, Two-thirds of voters there called health care a “very important” or the most important issue, according to one poll. In Maine, the state voted to expand Medicaid under the law, something their Republican governor had sworn not to do.
Enrollment under the law also appears strong in its first week -- the federal government released data Thursday showing that sign-ups in the first four days were higher than a year ago, when then-President Barack Obama’s administration was running it.
Trump’s repeated insistence that the law is a disaster, and Congressional Republicans’ attempts to repeal it, may have had the opposite effect than what they intended. Despite the administration slashing advertising for the enrollment period that started on Nov. 1, and other steps to destabilize it, early signs indicate people are embracing the health program.
Trump’s frequent attacks of the law may have only served to bring more attention to it, said Dan Mendelson, president of Avalere, a health care consulting company.
“The reality is that the administration has been aggressively messaging about the exchanges,” Mendelson. “They’ve actually done outstanding marketing so far. Awareness of the program has never been higher.”
Initial sign-up numbers for the first four days of enrollment in 2018 Obamacare plans in most states totaled more than 600,000, up 45 percent compared to a similar time period last year, according to the Centers for Medicare and Medicaid Services. Of those, 137,322 were new customers, instead of people renewing plans they already had under the law.
Those positive signs for the law are early markers, and could change.
The Maine and Virginia votes are just two states, and Democrats face a challenging electoral map in the Senate mid-terms next year. The administration also still has broad authority over how the law is run, and Republicans debating tax reform in Congress are talking about repealing a key plank of the program that requires all Americans to have coverage or pay a fine.
The enrollment season in most states lasts until Dec. 15, about half as long as last year. Karen Pollitz, senior fellow at the Kaiser Family Foundation, cautioned that it’s too early to draw conclusions about how many people will sign up, or whether the mix of sick and healthy customers will be profitable for insurers.
But the initial enrollment report lessens the fears “that this could be a real bust,” Pollitz said. The sickest often sign up early while healthy consumers wait until the end of the enrollment period to decide. Among voters, Democrat Ralph Northam’s opposition to the repeal helped him get elected, according to Public Policy Polling, which conducted the survey in the Virginia race.
“All this discussion about repeal made people aware that, ‘Wow, I should be grateful for what I have access to,”’ said Len Nichols, director of the Center for Health Policy Research and Ethics at George Mason University in Fairfax, Virginia. “There’s just way more consciousness to the value of health insurance than before they tried to repeal it.”
One of Trump’s own efforts to starve the law may actually have enticed some people to sign up. The president cut off funding for insurer subsidies under the Affordable Care Act that are meant to help low-income people cover health-care costs, a move that caused insurers to raise premiums even more.
Because of the way the law is written, the government was forced to increase the financial help it provides lower-income people to buy plans. That meant that for some people, the amount they have to pay out of pocket to buy coverage is actually lower than last year.
An analysis by the left-leaning think tank Center for American Progress found “hundreds of scenarios” in which consumers could gain coverage for $0. For example, a single 27-year-old that earns $25,000 a year could find coverage that would cost nothing in more than a quarter of 2,722 counties the group examined.
Particularly for low-income consumers, “they’ve really been very motivated about by being able to get insurance at no cost,” Avalere’s Mendelson said. The quirk doesn’t benefit higher-income people, who will have to choose between paying higher premiums or forgoing coverage.
States See Same
Officials in New York, Maryland, Massachusetts and California, which operate their own Obamacare marketplaces instead of relying on the federal sign-up system, also said early enrollment numbers are higher than last year.
In Maryland enrollments doubled to 10,000 in the first six days, said Andrew Ratner, chief marketing officer for the Maryland Health Benefit Exchange. That counts new enrollees and returning customers who actively logged in to change plans.
In Washington, the state’s exchange said that new enrollments were up by more than 50 percent. In Massachusetts, enrollment is up by 31 percent over last year through Nov. 9, Jason Lefferts, spokesman for the state insurance marketplace, said an email.
At CareSource, which sells policies in Ohio, Kentucky, Indiana, and West Virginia, overall sign-ups are higher than during the same period last year, said Steve Ringel, president of the health insurer’s Ohio market, exceeding projections.
The controversy around the ACA and attempts to repeal it “definitely has heightened awareness, and that heightened awareness has been a positive,” Ringel said. “Those consumers who are subsidized are finding very affordable care and options.”