CMS: Unsubsidized enrollment drops 40% on ACA exchanges from 2016 to 2018

A new Centers for Medicare & Medicaid Services report found that the unsubsidized population dropped by 40% from 2016 to 2018. (Getty/designer491)

A new Trump administration report found that 2.5 million unsubsidized customers left the Affordable Care Act’s (ACA's) exchanges from 2016 to 2018, a 40% decrease.

The Centers for Medicare & Medicaid Services (CMS) said in a report released Monday (PDF) that the decline in 2018 follows a decrease of 1.3 million unsubsidized people in 2017. But, enrollment in the subsidized population has remained steady, according to the report.

“While data from the effectuated enrollment report shows stability in exchange enrollment and premium trends, affordability remains a significant challenge for people who do not qualify for exchange subsidies,” CMS said.


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The report on effectuated enrollment, which details how many exchange customers have paid the first month of premiums, found that 1.3 million unsubsidized customers left the exchanges in 2017. Another 1.2 million unsubsidized customers left in 2018, the report said.

The declines coincided with premium hikes of 21% in 2017 and 26% in 2018.

But the report also looked at enrollment trends across states. Iowa had the greatest drop in unsubsidized enrollment, losing 85% of its unsubsidized population from 2017 to 2018. Georgia (60%) and Nebraska (59%) followed as second and third, respectively.  

The report also looked at the early effectuated snapshot for February 2019. As of March 15, there were 10.6 million effectuated customers on the exchanges for February 2019. In addition, the average monthly premium was $594, a 1% decline from the February 2018 average premium.

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CMS Administrator Seema Verma said that the unsubsidized drop shows that “Obamacare is failing the American people.”

But ACA advocates and Democrats charge that the Trump administration has contributed to the drop. They have pointed to several moves such as cutting funding for enrollment outreach and shortening the time period for open enrollment by half.

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