ObamaCare expected to suffer enrollment decline as Trump cuts timeframe

Fewer people are expected to sign up for ObamaCare coverage ahead of Friday’s deadline to enroll in the exchanges.

The Trump administration’s abbreviated enrollment period has left advocates acknowledging the numbers are almost surely going to be lower than the 9.2 million who signed up on HealthCare.gov at the end of the last open enrollment season.

It’s not clear how much the numbers will drop.

ObamaCare supporters have said the sign-ups so far have been higher than they anticipated in the face of what they view as the White House’s efforts to sabotage the health-care law. 

“Unfortunately, the Trump administration has cut [open] enrollment in half, as well as cutting the advertising and outreach budget, and so we are concerned that we won’t be at the same point as we were last year by any stretch,” said Cheryl Fish-Parcham, access initiatives director at Families USA, a liberal consumer health advocacy group.

Nearly 4.7 million people have signed up for coverage on HealthCare.gov this year as of Dec. 9, compared to the about 4 million who signed up at a similar point last enrollment season.

But there are only a few more days to add to that total, and little if any chance that the Trump administration will extend the enrollment period.

“The open enrollment period is shorter than prior years, so the pace of enrollment has to be more rapid for us to even have stable enrollment in the program,” said Dan Mendelson, president of Avalere, a health-care consulting company in Washington, D.C.

“If you normalize for the fact that it’s a shorter period, sign-ups are running behind for what they were last year.

Advocates have also hammered the administration for a 90 percent cut to ObamaCare’s advertising budget and a 41 percent funding decrease to state and local groups that help people enroll in coverage. The Trump administration has argued that the programs were ineffective, and contends that ObamaCare is a fundamentally flawed law that’s driven up premiums and limited competition.

To match last year’s HealthCare.gov enrollment of 9.2 million, 4.5 million more people would need to sign up for plans. This doesn’t include residents of 11 states and D.C. that have their own exchanges, many of which have longer enrollment periods.

“It’s likely sign-ups won’t match the 9.2 million in Open Enrollment 4, but it may not be a lot less,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation. “Open Enrollment 4” is a reference to the fourth year of enrollment under the health-care law last year.

A relatively small chunk of those enrollments will come from people who signed up on HealthCare.gov last year but didn’t pick a plan this year. They’ll be automatically re-enrolled in a similar plan, and Mendelson expects this will be the case for about 1.5 million people. 

Sign-ups typically surge around big HealthCare.gov deadlines. Last year, enrollment increased by 2 million from Dec. 10 to Dec. 17, since consumers had to sign up by Dec. 15 to have health insurance beginning Jan. 1 (the administration extended the deadline to Dec. 19 due to increased demand).

“I still think they can get a surge,” Fish-Parcham said. “Whether they’ll get a surge that’s as high as when there’s advertising, I doubt that they will.”

HealthCare.gov has previously had “waiting rooms” during high-traffic times around major deadlines, where consumers wait for access to the online insurance exchange. Call centers have also become bogged down in the past, both of which have lead the Obama administration to typically extend the deadlines by at least a few days.

The Centers for Medicare and Medicaid Services (CMS) hasn’t announced whether or not an extension will occur this year.

“The deadline for people to shop and pick a plan for the upcoming year is December 15,” a CMS spokesperson wrote in an emailed statement Monday. “We continue to encourage people to make plan selections by that deadline so that their coverage can begin on January 1.”

At the local level, groups that receive federal dollars to promote ObamaCare — known as navigators — are working furiously to sign people up for coverage before Friday.

“[My navigator team is] seeing a heavier volume of phone calls, a lot of them don’t even have appointment spots left,” said Catherine Edwards, the executive director of the Missouri Association of Area Agencies on Aging.

“We’re really busy, we’re crazy busy, which is a good problem to have,” said Jodi Ray, director of Florida Covering Kids and Families, which is affiliated with the University of South Florida. 

She added: “I would say that, at least with my navigators around the state, they’ve reported — and this is coming from all areas, even the rural areas — that this is the busiest open enrollment period they’ve ever had.”