Enrollment in the federal Affordable Care Act exchange market fell slightly year over year, federal data shows, in an environment experts said would discourage far more consumers from signing up.
More than 8.8 million consumers selected plans on the federal exchange during the open enrollment season, compared with about 9.2 million in the last season, according to information released by the Centers for Medicare and Medicaid Services, or CMS.
In the last week of open enrollment, more than 4.1 million consumers selected plans on the healthcare.gov platform. Open enrollment began Nov. 1 and ended Dec. 15 for states that use healthcare.gov to sign up consumers. The agency specifies "plan selections" as the total number of people who have submitted an application and selected a plan, excluding cancellations.
The agency announced in August that it would reduce the agency's outreach and advertising budget to $10 million from $100 million. In addition, it shortened the open enrollment period to seven weeks from three months through a final rule in April. Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a nonpartisan health research think tank, said that despite those actions from CMS, the enrollment number is "pretty good."
"I think a lot of people were expecting that the total sign-ups would fall well short of the number from last year," she said in an interview.
Pollitz added that state-by-state sign-ups closely matched figures from 2016. In some states, such as Nebraska, the number of sign-ups exceeded those of the previous season.
Furthermore, Chris Sloan, a senior manager at health research firm Avalere Health, pointed out that many states have yet to report their final ACA enrollment numbers.
Thirty-nine states and the District of Columbia use healthcare.gov to enroll individuals in health plans. When exchanges were first set up after the ACA went into effect, states were given the option to either create and manage their own exchanges or use the federal website.
CMS also extended the open enrollment deadline to Dec. 31 for states hit by hurricanes. Areas include the entire states of Florida, South Carolina, Georgia and Alabama, along with 53 counties in Texas, 20 parishes in Louisiana and 7 counties in Mississippi. All of Puerto Rico and the U.S. Virgin Islands have also been included.
Sloan said that when the final numbers are reported in March, there is a good chance they may exceed 2016's total. However, he cautioned that there are two ways to view the results: the first that they are "surprisingly good," but the second that they still show a floundering market due to regulatory uncertainty.
"This is a better-than-expected result, given all of the headwinds of the market," Sloan said. "But it is also a confirmation that this market is still not in great shape, and that it still faces headwinds going forward."