President Donald Trump’s whirlwind beginning to his time in office has left a shadow over the last few days of open enrollment for Affordable Care Act exchanges, with people questioning whether they should bother signing up at all.
“Some people ask, ‘What’s the point if the law is going to be repealed?’” Emily Black Bremer, an insurance agent in Clayton, Missouri, told The New York Times. “Should they rush to get in before the ACA is cut off? Should they give up because it’s all going away? It’s a tricky situation.”
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The president has been pushing for a speedy repeal to his predecessor’s signature healthcare legislation, and key parts of the law are expected to be rolled back as part of the congressional budget reconciliation process. What exactly will replace the ACA has yet to be revealed, though Republican leaders have suggested block grants for Medicaid or tax write-offs for physicians as possible elements.
The exchanges saw a spike in enrollment shortly after Trump was elected in November, according to the NYT, but for much of January, enrollment was far slower. Part of that is likely tied to the new administration’s decision to pull the plug on a multimillion-dollar advertising campaign designed as a final push to remind potential enrollees to sign up.
Pulling advertising during this crucial window can impact enrollment among younger beneficiaries, according to an article from Politico. That demographic is a key one for payers participating in ACA exchanges, as enrolling younger, healthier people offsets the higher costs associated with sicker individuals. Balancing the risk pool is key to stabilizing and maintaining the individual markets, experts have noted.
As of Jan. 14, according to the NYT, about 8.8 million people had enrolled in a health plan through Healthcare.gov, which serves 39 states. That figure is about 100,000 ahead of the previous year's enrollment, according to the article. However, one enrollment counselor interviewed by the newspaper said that after a huge spike in the beginning of December, enrollments dropped by 64% between Jan. 1 and Jan. 29 for her Florida-based group.
A drop in interest hasn’t been reported universally, however. Elsewhere in Florida, for instance, enrollees were placed into Healthcare.gov “waiting rooms” early Tuesday morning, signaling an influx of people trying to connect, according to an article from The Wall Street Journal.