Obamacare signups reach nearly 1.5M, still outpace last year after Week 2

Nearly 1.5 million people selected an Obamacare plan during the first two weeks of enrollment, the Trump administration said Wednesday, as sign-ups continued to outpace last year, suggesting surprising strength for the embattled health law.

Roughly a quarter of the customers were new to the markets, while the rest were re-upping in coverage, said the Centers for Medicare and Medicaid Services.

The brisk opening pace is noteworthy, since Obamacare supporters feared President Trump’s pursuit of repeal and moves to slash advertising and outreach would suppress enrollment.

But analysts said it’s too early to say whether the sign-ups mean the 2010 law is on firm footing.

For one thing, HealthCare.gov customers only have until Dec. 15 to sign up. Last year’s sign-up period lasted until Jan. 31.

“The open enrollment period is half of what it was. That means they have to average twice as many sign-ups per day to get to last year’s total,” said Robert Laszewski, a health policy consultant in Virginia. “Second, people in the individual health insurance market are just plain scared and confused after all they have heard about Obamacare from Trump and the Republicans this year. I have to believe many were eager to get their coverage assured early on.”

All told, sign-ups on the federal HealthCare.gov website are up about 45 percent this year — roughly 470,000 more customers signed up from Nov. 1 to Nov. 11 compared to the first 12 days of sign-ups last time.

About a dozen states run their own exchanges and will report their own figures.

Those on all sides of the health care debate are watching the 2018 numbers, which mark the first time a Republican president has been in charge of the enrollment season.

Mr. Trump shook the markets when he canceled “cost-sharing” payments that reimburse insurers who pick up low-income customers’ costs.

Insurers increased their rates in response, though subsidies designed to blunt premiums also rose, resulting in better bargains for people who qualify for taxpayer assistance on Obamacare’s exchanges.

“The fact that 4.5 million uninsured can find plans with premiums that cost zero dollars each month is likely helping to boost the number of new people who are signing up,” said Lori Lodes, who promoted the law as part of the Obama administration.

Still, she feared the lack of federal outreach to get customers eager to sign up will take a toll on numbers in the final weeks of enrollment.

“Most paid outreach occurs during this time and this is also when it has the greatest impact,” said Ms. Lodes, who launched the “Get America Covered” campaign to promote the law under Mr. Trump. “For example, the young and healthy tend to sign up when it’s close to the deadline and need the extra reminders that advertising provides.”

Also, analysts said ongoing attempts to dismantle the law might confuse customers or dissuade them from signing up in the coming weeks.

Senate Republicans on Tuesday said they plan to repeal the “individual mandate” requiring people to hold insurance as part of their tax overhaul. Analysts say 13 million fewer Americans will seek out insurance over the coming decade, freeing up more than $300 billion that would otherwise be spent on taxpayer subsidies for people who got covered.

Mr. Trump had been pushing the idea for weeks, eyeing the more than $300 billion in savings over the next decade that could be pumped into more tax cuts for average Americans.

“If the individual mandate repeal passes, I think it will inevitably suppress enrollment even though it doesn’t take effect until 2019,” said Timothy Jost, a law professor at Washington and Lee University who tracks the debate. “People are going to misunderstand what is going on and not buy, particularly those who don’t get tax credits. Some may also not pay their premiums and effectuate enrollment.”

Others said the mandate failed to bring healthier people into the risk pool in earlier rounds, so it might not be as big of a factor as it seems.

“I think we are down largely to the sick people who need the coverage,” Mr. Laszewski said.

Either way, the renewed debate is upending the debate over ways to stabilize the Obamacare markets.

Senate Minority Leader Charles E. Schumer said repealing the individual mandate will force insurers to raise premiums even more.

Mr. Schumer said it also could poison a bipartisan plan negotiated by Sens. Lamar Alexander, Tennessee Republican, and Patty Murray, Washington Democrat, to restore cost-sharing payments, empower states and offer slimmed-down plans to healthier customers.

“They are completely contradictory ideas. Alexander-Murray is meant to stabilize the marketplaces and lower premiums,” said Mr. Schumer, New York Democrat. “The Republican [tax] plan destabilizes markets and raises premiums in a way that Alexander-Murray could never repair.”

Mr. Alexander said the tax bill, which Democrats say they oppose, is moving separately from his stabilization bill, which has enjoyed widespread support from Democrats so far.

“It would hard for me to see how they could then turn around and vote ’no,’” he said.