Initial enrollment in Obamacare drops by 1.4 million as expiring ACA subsidies drive up premiums
About 1.4 million fewer people have signed up for Obamacare insurance this year, according to an early report, even as premiums rose sharply after the expiration of expanded subsidies that helped lower the cost of health insurance for millions of Americans.
Figures released Monday by the federal government suggest 22.8 million Americans have enrolled in Affordable Care Act plans since Jan. 1, compared with 24.2 million by the end of the enrollment period last year. These are the first official figures showing the effects of the policy change.
The new dates refer to registrations up to January 3rd. People can register until Thursday. Comparing the new data to a similar period last year, enrollment fell by 800,000 people, compared to 1.4 million for the entire enrollment period last year.
Many health policy experts expect enrollment to continue to decline in the coming months as people whose policies were auto-renewed may decide to cancel coverage as soon as they receive their first bill with a much higher price.
“It’s really too early to tell,” said Cynthia Cox, senior vice president at KFF, a nonprofit research group that tracks the Affordable Care Act. She said initial enrollment numbers reported were higher than expected, but the final number won’t be announced for months.
Andrew Nixon, a spokesman for the Department of Health and Human Services, attributed the drop in enrollment largely to anti-fraud measures, not higher insurance costs. The Trump administration has tightened income and document checks for some enrollees in an effort to reduce the number of those who earn too little to qualify for subsidies.
The decline, he said in a statement, “is largely due to CMS cracking down on fake and illegitimate marketplace applications.”
Still, Congress continues to debate options to soften the financial blow to consumers, but lawmakers have failed to agree on a solution. The House of Representatives has passed a bill to expand supplemental insurance subsidies first introduced during the Covid pandemic, but the Senate has already considered (and rejected) an identical measure.
A bipartisan group of senators met to discuss a compromise plan that would extend some funding to consumers with more restrictions. However, the details of this plan have not yet been finalized and its prospects for passage remain unclear.
President Trump expressed ambivalence about the insurance subsidies. It was only in November that the White House put forward a proposal to extend funding. And just last week, the president told Republicans they should be flexible in considering options on related abortion restrictions, a remark that illustrated his interest in compromise.
But when asked about the bill during a trip on Air Force One on Sunday, Mr. Trump said he could veto the legislation.
Due to the expiry of the special subsidies, the amount that people have to pay for insurance has doubled on average. The Congressional Budget Office estimates the outcome will leave two million more Americans uninsured this year. However, other analysts assume larger losses in coverage.
Adrianna McIntyre, an assistant professor of health policy at Harvard, said she expects the final enrollment number could drop by several million in the next few months. “I don’t think this is the final number,” she said.
Consumers will still have until Thursday to sign up for plans with coverage that goes into effect on February 1st. After that, the annual open enrollment period for people who sign up through the federal marketplace will have ended, barring congressional action, and most people may have to wait until next year to sign up.
