Trump administration report shows ACA exchange signups are off to strong start

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CMS says 137,322 of the plan selections for the first four days of open enrollment have been new customers, while the remaining 464,140 actively renewed their coverage.

It’s official: The 2018 open enrollment season for Affordable Care Act exchange plans is off to a roaring start.

A little more than 600,000 people signed up for coverage on Healthcare.gov during the first four days of open enrollment, according to a weekly enrollment report from the Centers for Medicare & Medicaid Services. On average, that’s about 150,000 signups per day.

By comparison, last year’s first enrollment report showed there were about 1 million signups in the first 12 days of open enrollment, averaging out to roughly 84,000 per day.

No information is available about the total number of signups for just the first four days of the 2017 enrollment period, as the Obama administration issued only biweekly reports. The Trump administration releases enrollment figures on a weekly basis, but its first report captured only four days because open enrollment started on a Wednesday.

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CMS’ report also noted that 137,322 of the plan selections for the first four days of open enrollment have been new customers, while the remaining 464,140 actively renewed their coverage.

Those results come amid predictions that enrollment in ACA plans would be down this year, given the Trump administration’s cuts to advertising and outreach, a shortened signup period, and confusion about the status of the healthcare law given Republicans’ attempts to repeal it.

It’s possible that all the attention given to the ACA in recent months—positive or not—fueled increasing awareness of it, according to Lori Lodes, who was a CMS official under the Obama administration and now runs a campaign called Get America Covered.

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“The administration has caused a lot of anxiety for people over the last year when it comes to healthcare, but there’s also been a more in depth conversation about what Obamacare really is about,” she wrote in a post on Medium. “So when most people logged onto Healthcare.gov they found plans that are more affordable than they expected.”

Indeed, while premiums for benchmark silver-tier plans rose an average of 37% in 2018, tax credits rose along them, by an estimated 45%. The result, according to an analysis by the consulting firm Avalere, is that in nearly 98% of counties with exchanges operated by Healthcare.gov, a 50-year-old making about $18,000 a year could purchase a bronze plan for no monthly premium.

Because much of the subsidy-eligible population can find a plan with no premium, “despite the administration’s efforts, people are getting covered,” former CMS Administrator Andy Slavitt said in an email.

Editor's note: This article has been updated to include comment from Andy Slavitt.