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Despite Changes That Undercut ACA Enrollment, Marketplaces 'Remarkably Stable'
09 February 2018, 05:19 | Rodolfo Quinn
ACA's state-run insurance exchanges fare better than the law's federal marketplace
In states relying on the federal exchange, the enrollment period this year was reduced to six weeks, while many states with their own marketplaces continued for two or three months.
With the Trump administration taking steps to undercut these marketplaces and congressional Republicans having spent much of previous year trying unsuccessfully to dismantle large parts of the ACA, leaders of state insurance exchanges and other health-policy experts said that enrollment was surprisingly resilient. Also, insurers hiked premiums for many plans amid the uncertainty in Washington, D.C. and President Trump's elimination of funding for Obamacare's cost-sharing subsidies. Overall, the 39 states that use the federal website saw their enrollment slip by about 5 percent.
Still, the burden of higher premiums would fall on the 6 million or so people who buy their own insurance but don't get a federal tax credit to help them purchase coverage, according to an earlier study done by Covered California.
But in a marked contrast, two-thirds of the marketplaces run by states instead of the federal government saw increased enrollment between 2017 and 2018, including CT and NY.
The Centers for Medicare and Medicaid Services is expected to release its comprehensive review of 2018's open enrollment period in coming weeks.
While premiums climbed, the overall effect on enrollment is unclear.
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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.
Rhode Island (12.1%), Kentucky (10.4%), and Washington State (7.6%) saw the largest share increases in signups, while Louisiana (-23.5%), West Virginia (-19.5%), and Arizona (-15.6%) had the largest drop in shares of signups. He highlighted that almost 390,000 new consumers signed up for coverage, an increase of 5% over the prior year.
The outlook for next year, however, remains unclear.
"While we've seen remarkable stability in 2018, 2019 looks very troubling", Lee said, noting that premiums could rise by 30% in some states.
The difference, according to NASHP, was state-based exchanges used "effective communication"-since they didn't cut their advertising budgets like HHS-to reach out to key populations who may be eligible for larger subsidies, shielding them from the double-digit premium increases seen across the country". It is in the process of relaxing federal regulations to allow the sale of more insurance policies that don't adhere to Obamacare's mandates, for instance.
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