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ACA Marketplace Sign-Ups Outpacing Last Year, Despite Sabotage

The 2018 open enrollment period for Affordable Care Act (ACA) marketplace coverage is off to a fast start, with over 600,000 customers selecting plans in the first four days compared to 416,000 during the first five days of last year’s period.

We don’t yet know what’s driving the increase and how signups during the open enrollment period as a whole — which the Trump Administration has cut in half — will compare to last year. But we do know that ACA supporters have amplified their enrollment efforts to combat the headwinds that the marketplaces face this year due to Trump Administration actions to sabotage the ACA. And we know that many consumers coming to the marketplace have found great deals, which also may be driving up enrollment.

Enrollment assisters and other ACA supporters are finding ways to maximize their efforts during the shortened enrollment period. For example:

  • Before open enrollment started, Florida assisters began calling prior enrollees and consumers who expressed interest in the past but didn’t enroll. In one part of the state, the resulting increase in demand for enrollment appointments forced the assister organization to add new enrollment events to its calendar.
  • New groups joined this year’s enrollment drive to help fill the gap left by the Administration’s decision to drastically cut outreach funding. For example, the Obama Administration’s ACA outreach leaders created a new organization to raise awareness about marketplace coverage. The group has created an open enrollment tool kit and materials to promote enrollment through social media, among other things.

Many consumers are finding health plans that meet their budgets and health care needs, consumer assistance organizations report. Premiums have generally risen, but consumers eligible for ACA premium tax credits are largely shielded from the hikes because their credits rise when the cost of coverage rises.

In fact, while health plan costs vary by state, costs for subsidy-eligible consumers have often fallen this year, according to the Kaiser Family Foundation. For example, a 40-year-old earning $35,000 in 2018 would on average pay 39 percent less than last year for the lowest-cost bronze plan, 7 percent less for the lowest-cost silver plan, and 13 percent less for the lowest-cost gold plan.

The vast majority of marketplace customers are eligible for subsidies, and about 80 percent of enrollees this year have the option to enroll in a plan that costs less than $75 per month after accounting for their tax credits. Many subsidy-eligible consumers can find bronze plans at very little cost. For example, a couple who are both 55 living in Falls Church, Virginia with expected income of $50,000 could enroll in a bronze plan at no cost. If they wanted more comprehensive coverage, they could enroll in a sliver plan for $363 a month.

With good deals on health plans and extensive private efforts to raise awareness, marketplace enrollment may indeed exceed expectations. But to match last year’s sign-up levels during the shortened open enrollment, the pace of sign-ups will have to increase substantially in the remaining weeks.