President Donald Trump declared Obamacare dead Wednesday after Congress passed its deeply unpopular $1.5 trillion tax overhaul bill. “Obamacare has been repealed in this bill,” he told reporters. Not only was he factually incorrect — as the bill only repeals the tax penalty for not having insurance — his statements were premature.
The Centers for Medicare and Medicaid (CMS) released its open enrollment estimate numbers on Thursday, revealing that approximately 8.8 million people enrolled in plans on Healthcare.gov. The numbers underscore the durability of the Affordable Care Act (ACA) federal marketplace and the value that the public apparently places in health insurance.
Exchange open enrollment for 2018 coverage ended w/ approx 8.8M people enrolling in coverage. Great job to the @CMSGov team for the work you did to make this the smoothest experience for consumers to date. We take pride in providing great customer service.
— CMS Administrator (@SeemaCMS) December 21, 2017
By comparison, 9.2 million people signed up for coverage last year. This year’s forecast took many health experts by surprise because the open enrollment period was halved. Additionally, the Trump administration had taken numerous steps that undermined open enrollment, including slashing funding for outreach and marketing and running only negative advertisements about the ACA.
These estimates aren’t the final tally — just Healthcare.gov sign-ups. A handful of states set up their own exchanges, and states like California and New York are still enrolling people in coverage. Ultimately, people still need to pay their premiums — some people may drop coverage if they can’t afford to pay. Estimates will not be final until next year.
“Obamacare survived the first year of President Donald Trump, but it’s badly damaged,” wrote Politico’s Joanne Kenen who’s covered the ACA since its inception.
For all the damage, marketplace sign-ups fared well, so far. And the ACA implemented more than just the marketplace. Current health law prevents insurance companies from locking out people with pre-existing conditions and expanded Medicaid eligibility.
While the president’s October executive order is likely to introduce skimpy health plans next year that could further hobble the marketplace, Senate Majority Leader Mitch McConnell (R-KY) told National Public Radio he wants to move on from repeal efforts next year.
The ACA twists and turns — from the GOP’s efforts to repeal and replace the entire health law, to the president’s issuance of an executive order weakening the law that goes into effect next year — have made it an especially confusing time for consumers shopping on the marketplace. But advocates invested in the current health law have been trying to steer people toward enrollment, as the ACA is still current law — including the individual mandate, at least until 2019:
The 7 Most Important Things to Remember for 2018 Open Enrollment: https://t.co/kTnROtNMrI #ACA #GetCovered pic.twitter.com/3L1Dzvreqr
— Charles GetCoveredBa (@charles_gaba) November 18, 2017
“The demand for affordable coverage speaks volumes – proving, yet again, the staying power of the marketplaces,” said Get America Covered co-founder Lori Lodes to reporters. Lodes is an Obama administration veteran who helped launch Get America Covered because the current administration would not advertise the marketplace.
Many felt vindicated by Thursday’s numbers, despite likely not meeting last year’s enrollment figure.