ACA enrollments decline 3 percent

Covered California Sees Slight Drop In Renewals

ACA's state-run insurance exchanges fare better than the law's federal marketplace

Enrollment there is up 12 percent this year, he said, with sharp increases in the number of newly enrolled and policyholders aged 18 to 34. If the lower-cost plans catch on with consumers, it could siphon healthy people away from the health law's comprehensive coverage.

Covered California - the state's health insurance marketplace - saw an increase in new enrollees previous year.

Overall ACA marketplace signups for 2018 dropped by 3.7 percent compared to last year's enrollment period, a new analysis from the Kaiser Family Foundation finds.

While the state exchange directors said Obamacare remained strong this year, they were concerned about Congress' elimination of the individual mandate starting in 2019. The Trump administration also slashed outreach and advertising funding.

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People who are eligible for health law subsidies would be shielded from such increases, but those who don't get financial assistance would face another round of premium hikes. While the proposals have bipartisan support - and the idea is endorsed by many health industry groups - the legislation faces opposition from some lawmakers who see it as a bailout for the insurance industry.

That has been particularly tough for consumers who make too much to qualify for federal insurance subsidies through the health care law.

"Just the removal of the [individual mandate penalty in Congress' recently enacted tax overhaul] will mean premiums go up 15 percent to 30 percent or more depending on the state", said Lee. "More people may have job-based coverage as an option and not have a need for Covered California because they're getting health care coverage through their employer". Enrollment isn't final until consumers pay their first month's premium.

States which have their own marketplaces fared better.

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California's enrollment dipped slightly in 2018, falling 2.3 percent, but the state saw a significant increase in new consumers, which was an encouraging sign, said Peter Lee, head of Covered California, the state's marketplace.

States that run their own marketplaces overcame some of those challenges, according to NASHP, through efforts such as conducting targeted outreach to key populations and improving their enrollment operations.

"We could extend our open-enrollment period, control our marketing budget and nimbly mitigate the impact of the loss of cost-sharing subsidies [to insurers], which led to a very successful open enrollment", said Zachary Sherman, director of Rhode Island's state-run market.

In fact, of the 12 jurisdictions running their own exchanges, eight gained enrollees - only California, the District of Columbia, Maryland and Vermont lagged behind 2017 levels.

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