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January 15, 2017

Health insurance – and the state of healthcare in the U.S. – has topped news headlines for months thanks to ongoing debate in Congress over how to handle the Affordable Care Act. No new law has replaced former President Obama’s signature legislation, but confusion abounds as we head into the third week of open enrollment 2018. If you need health insurance for next year, now’s the time to sign up. Fortunately, there are still affordable options for major medical coverage, a fact that over half a million people have taken advantage of already. In the first week of open enrollment, over 600,000 people signed up for a health plan on HealthCare.gov, and that doesn’t even include anyone using a state-based marketplace or a private, off-market option.

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No Outreach? No Problem

The Trump administration’s latest efforts to curtail spending on advertising and outreach drew sharp criticism from opponents, primarily those who know that getting the word out about Obamacare – a hard task already – would be made nearly impossible with a substantially reduced budget. President Trump cut advertising down by about 90 percent, leaving just $10 million to get people on board for health insurance in 2018. In a similar move, the administration also reduced funding for the navigator program by around 40 percent. Navigators help people understand the complex system hosted on HealthCare.gov.

Despite these efforts to limit outreach on Obamacare, American consumers flocked to the federal site in the first four days of open enrollment, some for the first time. Around 23 percent of those who signed up for a healthcare plan on the federal marketplace were new to the exchange. As with any enrollment period, most customers are returning from the previous year. When compared against past enrollment seasons, the first week of 2018 open enrollment is even more promising:

  • In November 2014, approximately 66,000 people signed up for health insurance per day during the first week of open enrollment;
  • The following year, November 2015, the per-day total averaged to around 77,600 people;
  • The daily average for enrollment increased to 84,000 in November 2016; and
  • This year’s first week of enrollment saw around 150,000 per day sign up for a health insurance plan on the federal site.

Skeptics are quick to point out that early enrollment figures may not paint an accurate picture of total enrollment for the year. These early numbers could fluctuate widely as people fail to pay premiums, change their mind about coverage or choose a job-based health plan instead. The Centers for Medicare and Medicaid Services (CMS), which tracks the ongoing signup tally, is only reporting numbers for the 39 states that depend on HealthCare.gov for enrollment. CMS may include state-based figures later in the season.

Curious Shoppers

The CMS is also reporting an increase in site traffic and window shopping for the federal exchange. More than 1.3 million people submitted an application during the first week of enrollment. While these customers haven’t completed the enrollment process, the sheer volume of submitted applications indicates that Americans are still pushing for and in desperate need of affordable health insurance despite efforts to repeal and replace Obamacare. HealthCare.gov received over 2.5 million visitors during the first four days of enrollment, and over 500,000 people called in to the site’s customer service line for assistance.

Affordable Exchange Plans

Many customers on the exchange this year may be pleasantly surprised by their options for affordable coverage in 2018. Much of the healthcare news lately has focused on Trump’s decision to end cost-sharing reduction payments to insurers. These payments are federal reimbursements to companies that reduce out-of-pocket costs to lower-income customers. Without these reimbursements, insurers would lose millions of dollars because they’re required by the ACA to lower out-of-pocket costs regardless of whether the government pays them to do so or not. As a result, premiums have skyrocketed for next year. In some states, premiums will jump by over 50 percent or more.

But because of some weird math, an unexpected and likely unintended consequence of Trump’s decision to end cost-sharing reduction payments is that premiums for most people on the marketplace could actually go down – and in some cases, customers could get a better plan with more coverage for less money. According to the Kaiser Family Foundation, about 4.5 million people (42 percent of the uninsured population) could sign up for a bronze plan on the marketplace with a zero-dollar premium thanks to tax credits. Even better, of the uninsured population that qualifies for tax credits to reduce monthly premium costs, 70 percent would pay less in premiums than they would in penalty fees for not having health insurance.

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Open enrollment for 2018 coverage runs from November 1 through December 15 in the states that use HealthCare.gov as their Obamacare exchange. For states with state-based marketplaces, deadlines vary, with some extending into the end of January. If you haven’t started the process yet and you need health insurance next year, now’s the time to get the ball rolling.