ACA enrollment drops 8% in second week

Week two of open enrollment shows an 8 percent drop in the number of people signing up for Affordable Care Act coverage.

From Sunday, Nov. 4 to Saturday, Nov. 10, 804,556 people selected a plan through Healthcare.gov, according to the Centers for Medicare and Medicaid Services. Of these, 185,631 are new consumers.

CMS measures enrollment Sunday through Saturday.

Last year, from Nov. 5 to 11, 876,788 people selected plans, a 72,232 increase over this year.

Cumulative numbers between this year and last are hard to compare as 2017 had an extra day during week one.

This year, cumulative enrollment since November 1 is 1,176,232. In 2017, that number was 1,478,250 people.

This year, 274,913 are new Healthcare.gov consumers compared to 345,719 last year.

WHY THIS IS IMPORTANT

The ACA market has finally seemed to stabilized for insurers this year, with an additional 23 more issuers offering plans and premium rates in some cases decreasing.

Insurers are invested, but questions remain as to whether the loss of the individual mandate to buy insurance, and the new availability of less expensive coverage through short-term limited duration plans, is siphoning off consumers, as predicted.

If the lower numbers of enrollees this year means consumers who would otherwise have insurance under the ACA are going without coverage, then providers will face the resulting uncompensated care costs.

THE TREND

The Affordable Care Act market has been on a bumpy ride since plans became effective in 2014. Early on, insurers underpriced their plans and lost money. Many payers pulled out or pulled back from the market or increased their premium rates.

Under the Trump Administration, the ACA came close to repeal. The administration cut back 90 percent of marketing efforts, reduced funds for Navigators to help consumers find a plan and shortened the length of time for open enrollment.

Insurers lost some stabilization measures such as the cost-sharing reduction payments, but this year the administrative allowed them to silver-load their plans to make up for the loss. CMS took credit for other stabilizing measures such as easing regulations and offering waivers to allow states to set up a reinsurance program for insurers to submit high cost claims into a risk pool.

Through all of the changes, the ACA has remained popular with consumers, but an October survey found that the majority of people were confused over benefits and when open enrollment would begin. About a quarter thought the law had been repealed.

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com