Health & Spirit

Fewer people signing up for Affordable Care Act as Trump pushes other options

John Tozzi, Bloomberg News on

Published in Health & Fitness

The market for "Obamacare" plans is shrinking but not collapsing, two years after President Donald Trump said not repealing the program would "destroy American health care forever."

More than halfway through the 45-day enrollment period, fewer people have selected plans for 2019 on than in the same period a year ago, new government data show. The website handles enrollment in Affordable Care Act plans for 39 states.

The decline in signups follows an effort by the Trump administration to promote cheaper coverage with fewer consumer protections, which critics called an attempt to undermine Obamacare. Congress also lifted the individual-mandate penalty for going without health insurance -- a fee of 2.5 percent of income that was intended to discourage healthy people from waiting until they got sick to purchase coverage. That change takes effect in 2019.

The number of people signing up for ACA plans is "surprisingly robust, given all the headwinds," said Larry Levitt, senior vice president for health reform at the Kaiser Family Foundation, a research group.

Signups between Nov. 1 and Nov. 24 totaled 2.4 million, about 13 percent less than during a similar period last year, according to data released Wednesday by the Centers for Medicare and Medicaid Services. enrollment closes Dec. 15. At that point, participants who didn't actively shop for new coverage will be automatically re-enrolled. It's hard to gauge how much the market may be changing until those final numbers are released.

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Premiums, after jumping for several years, are on average stable for next year. And while some states scrambled to find insurers in rural areas where no companies wanted to sell coverage last year, every spot on the map had at least one option for 2019.

About 80 percent of those buying coverage on and state marketplaces are eligible for subsidies because they make less than $48,000 a year for an individual, or $100,000 for a family of four. That insulates them from price increases.

The remaining 20 percent on the exchanges, as well as millions who shop for similar plans outside of those official market websites, pay the full premium. Those prices strain many household budgets, causing some people to seek cheaper alternatives or drop coverage entirely.

The data released Wednesday count only purchases on, not people who bought coverage off the exchanges. That market could be changing more dramatically, because buyers pay the full price.


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