Affordable Care Act Sign-Ups Dip Amid Uncertainty and Trump Attacks
By ROBERT PEAR
FEB. 3, 2017 - The New York Times
— The number of people who signed up for health insurance in the federal
marketplace that serves most states dipped this year to 9.2 million, the Trump
administration said Friday, as consumers struggled with confusion over the
future of the Affordable Care Act.
represents a decline of more than 4 percent from the total of 9.63 million
people who signed up through HealthCare.gov at this time last year.
numbers do not include activity in the 11 states that run their own online
marketplaces under the Affordable Care Act, former President Barack
Obamafs signature health
care law. State reports suggest that they have signed up about three million
Veterans of the Obama administration said President
Trumpfs opposition to the health law and his efforts to undermine it had taken a
toll. People may also have been influenced by signals from Congress that the law
would soon be repealed. And some consumers may have been put off by the
termination of their health plans, which was caused by an exodus of major
insurers from the market in many states.
Just before leaving office, the
Obama administration reported that sign-ups through HealthCare.gov were running
slightly ahead of the number at the same time last year, with 8.8 million as of
gTrumpfs sabotage worked,h said
Ben Wakana, who was a spokesman for Sylvia Mathews Burwell, the secretary of
health and human services under Mr. Obama. gWe were on track to exceed last
yearfs total. We expected a million people to sign up on the federal exchange in
the final week of the open enrollment period.h
Still, the numbers present a challenge to Republicans who
are struggling to repeal the law that allowed those millions to purchase
insurance plans — and who have promised not to displace anyone covered by
The fourth annual open enrollment season began Nov. 1 and
ended Tuesday, 11 days after Mr. Trump took office.
The Trump administration scaled
back publicity and advertising in the final days of the open enrollment
period. Mr. Trump also issued a
broadly worded executive order that directed federal officials to waive or
delay any provision of the Affordable Care Act that would impose ga cost, fee,
tax, penalty or regulatory burden on individuals.h
The order, issued within hours of Mr. Trumpfs inauguration
on Jan. 20, did not specify what actions would be taken. But lawyers and health
policy experts read it as an indication that the government might not enforce
the federal requirement for people to have health insurance or pay a tax
Mr. Trump has described the Affordable Care Act as ga
complete and total disasterh and has said he wants to replace it with better,
cheaper coverage gfor everybody,h but he has not offered a plan to achieve that
Senator Orrin G. Hatch, Republican of Utah and chairman of
the Finance Committee, who is trying to draft a replacement for the law, said
that gtodayfs numbers failed to keep pace with last yearfs.h In addition, he
suggested, some people who signed up will not pay their premiums and will
therefore not have coverage this year.
gEither way,h Mr. Hatch said, genrollment numbers are down,
and costs are up.h
That response was predicted by Representative Nancy Pelosi
of California, the House minority leader and an architect of the law.
gNow, Republicans will cynically
point to the dip in enrollment they caused, declare the Affordable Care Act
broken and move to steal the affordable health coverage of every American,h she
said. gMeanwhile, in states committed to delivering affordable health coverage
to their residents, enrollment in the Affordable Care Actfs marketplaces has
gDemocrats will continue to stand our ground to ensure
that every American has access to affordable health coverage,h she added.
Enrollment reports from the Obama administration were
invariably upbeat, saying the numbers showed that people needed and wanted
insurance under the Affordable Care Act.
The first report from the Trump administration struck a
gObamacare has failed the American people, with one broken
promise after another,h Matt Lloyd, a spokesman for the Department of Health and
Human Services, said Friday. gPremiums in the A.C.A. marketplace have increased
25 percent while the number of insurers has declined 28 percent over the past
Of the 9.2 million people who signed up through
HealthCare.gov, one-third were new to the federal marketplace, and two-thirds
were returning customers. The individual insurance market is in constant flux.
With changes in income and employment, consumers may gain or lose coverage from
employers and other sources of insurance.
The Obama administration predicted in October that 13.8
million people would sign up for coverage in the enrollment period that ended
this week. The total appears likely to fall short of that goal.
Leslie Dach, a former Obama administration official who is
trying to preserve the health law as a leader of the Protect Our Care Coalition,
said, gEnrollment was a success, and it would have been even higher without the
Trump administrationfs efforts to suppress enrollment.h Despite those efforts,
he said, gAmericans continued to enroll in the final weeks, proving that there
is considerable demand for quality and affordable coverage.h
Several states that run their own insurance exchanges
appear to have done better than the federal marketplace. In New York, 908,200
people signed up through the state marketplace for either a qualified health
plan or the gbasic health programh authorized by the Affordable Care Act for
low-income people. That represents an increase of 39 percent.
Under the Obama administration, enrollment in marketplace
insurance plans was consistently lower than the levels originally projected by
the Congressional Budget Office, in part because consumers were more likely to
get and keep employer-sponsored insurance.