The final tally for Healthcare.gov sign-ups is 8.7 million—a slight downgrade from the 8.8 million-plus enrollment total that the Trump administration previously announced.
The dip of about 78,000 plan selections was due to late cancellations, a Centers for Medicare & Medicaid Services spokesman told the Associated Press. Enrollment data from states that run their own exchanges—many of which had longer enrollment windows—won’t be available until March, according to CMS.
As in past years, the Affordable Care Act exchange enrollment total is likely to drop from the initial count, since some consumers will fail to effectuate their coverage.
Even so, the 8.7 million plan selections on Healthcare.gov is an impressive accomplishment for the ACA, which has been surprisingly resistant to Republicans’ repeated attempts to unwind it.
In fact, more than 4 in 5 people who signed up for plans on the federal exchange hail from states that President Donald Trump won in the 2016 election, per an AP analysis of the enrollment data released before Christmas. Of the 11 states that beat 2017’s enrollment figures, eight of them went for Trump.
This year’s enrollment total for the federal exchange is also not far off from that of the year prior. During the 2016-2017 open enrollment season—which was twice as long—9.2 million people selected plans on Healthcare.gov. In other words, enrollment dropped about 5% year over year, despite one analyst’s prediction that sign-ups for 2018 plans would be anywhere from 7% to 13% lower than the year prior.
Part of what fueled worries about lower sign-up levels was the Trump administration’s decision to slash open enrollment advertising and outreach funding. One analysis found that health insurers have stepped up to fill the void of TV ads, though researchers cautioned that private ads aren’t a substitute for federal advertising that explicitly steers consumers to Healthcare.gov.
ACA-friendly states have also amped up their advertising efforts. Covered California, for example, had a marketing budget that devoted $45 million to ads—dwarfing the $10 million set aside by the feds to market Healthcare.gov.