Obamacare sign-ups down 3.7%

Covered California Sees Slight Drop In Renewals

Some 11.8 million people selected plans on the federal and state-based exchanges, down 3.7% from previous year, according to the National Academy for State Health Policy.

Leaders from those states said it also helped that an increase in federal subsidies lowered costs for many customers and that heightened news coverage of the ACA helped boost awareness.

"We had the best open enrollment period we have ever had", said Allison O'Toole, chief executive of Minnesota's insurance marketplace, known as MNsure, which saw enrollment surge almost 6 percent this year.

As a group, the 15 states plus the District of Columbia with state-based marketplaces, including those using the Healthcare.gov enrollment platform, exceeded last year's totals this year by.2 percent, while the 34 states that relied on the federal healthcare.gov marketplace saw total signups drop by about 5.3 percent.

States which have their own marketplaces fared better. State-run marketplaces tended to have longer sign-up periods and some invested heavily in marketing.

The new enrollment numbers - which include totals from California and other states that operate their own marketplaces, as well as states that rely on the federal HealthCare.gov marketplace - offer the most detailed picture to date of the insurance markets.

In a recent interview, Lee said he's concerned that the federal government isn't doing enough to advertise that coverage is available at attractive rates for people with modest incomes who qualify for subsidies.

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People who are eligible for health law subsidies would be shielded from such increases, but those who don't get financial assistance would face another round of premium hikes.

Despite their upbeat tone about this year's enrollment, directors of several state marketplaces warned that 2019 looks grim.

"Not promoting enrollment is a formula for higher premiums for many Americans", said Lee. "It's gone", Trump declared on the eve of the 2018 open enrollment period, which began November 1.

The report also showed that enrollment dropped sharply in some states. The standouts included Rhode Island, which saw a 12.1% increase, and Washington, which had 7.7% more people pick plans.

"In the end, insurance coverage and enrollment [are] a local issue and states all have different priorities and goals", said Heather Korbulic, executive director of Nevada Health Link.

Congress should act soon to mitigate those expected increases, according to the five state exchange directors who participated in a press call detailing the report's findings, by providing funding for states to create reinsurance programs, which pay insurers for medical costs for the most expensive enrollees.

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