Day after Trump elected, ACA enrollment surges

Consumer enrollment in the Affordable Care Act marketplace the day after the election is strong, according to a tweet posted Thursday by Health and Human Services Secretary Sylvia Burwell.

On November 9, 100,000 plans had been selected on HealthCare.gov, she tweeted.

"Best day yet this Open Enrollment," she said. "Consumers shopping & enrolling."

The Centers for Medicare and Medicaid Services has yet to release its traditional weekly enrollment update more than a week after  enrollment began on November 1. However, CMS held off launching its full marketing and outreach efforts until Wednesday, due to consumer focus on the presidential election.

A CMS spokeswoman said Thursday she didn't know when an enrollment snapshot would be released.

[Also: Reports shows catastrophic rise in uninsured rate should Affordable Care Act be repealed]

CMS declined further comment on what the election of Republican Donald Trump means for ACA plans. Insurers contacted have also declined to comment.

President-elect Trump and top Republicans have said repealing the Affordable Care Act is a top priority, with speculation that this could be done through budget reconciliation.

[Also: Here's what Donald Trump's Obamacare replacement could look like]

Even if Republicans quickly come up with a replacement plan that offers a smooth transition for the 20 million consumers already enrolled in the ACA, it would be some time before consumers and insurers know whether current benefits, or the legal requirement to have insurance, remain meaningful.

The stock market and investors responded to the uncertainty accordingly.

Universal Health Services fell 6.9 percent, HCA Holdings lost 10.8 percent of its value and Centene - which saw a sell-off by a major investor this week - gave up 19 percent of its value on Wednesday, according to InvestorPlace.

Some hospital stocks have taken a beating based in part on investor fear that providers may once again be forced to treat patients even if they are unable to pay for the services, Fitch Ratings said.

While other major insurers such as UnitedHealth and Aetna, have already withdrawn from many of their ACA markets due to financial losses, Centene has realized success under the law.

That future is now unclear.

Many states hire managed care providers such as Centene to insure its Medicaid members. Under the ACA, the federal government provided funding to allow states to expand their Medicaid programs.

With a repeal of the ACA, the future of Medicaid expansion remains uncertain for the 19 states that have not yet implemented the law, and for the 31 states and District of Columbia that have. 

[Also: Uninsured would drop by millions, enrollment would swell if Medicaid expansion holdouts opted in]

Centene did not immediately return a request for comment.

Retaining certain key aspects of the ACA is a possibility, according to Fitch. Analysts believe Republicans will likely balance their interests in meeting campaign promises to repeal the act while not alienating voters who had historically been uninsured prior to the ACA's implementation, according to the Insurance Journal's reporting on Fitch analysis.

Centene CEO Michael Neidorff reportedly told the St. Louis-Post Dispatch Wednesday the market was having a "gross overreaction" to the election, and he expected the company's stock to rebound.
 
While Trump and the Republicans have been clear on their desire to repeal the Affordable Care Act, there is less clarity on their healthcare policies, except for the focus on reducing regulations, according to MorningStar.

As plans take shape to repeal the ACA, the likely outcome will be more of a modification than a complete repeal as several groups have benefited from the legislation, according to Morningstar. If the ACA were repealed, the outcome would likely mean a lower demand for healthcare combined with less industry fees and profit restrictions, it said.

"The passage of ACA was largely a compromise with industry stakeholders, mandating increased insurance coverage in return for lower costs," Morningstar said. "Reversing this mandate is largely a net neutral to the healthcare sector, with the drug, biotech, and insurance industries slightly benefiting, hospitals and drug supply chain firms negatively impacted, and the remaining industries less influenced."

Twitter: @SusanJMorse