Lower premiums and more plan choices did not attract more Americans to sign up for Obamacare plans for 2020.
Some 8.3 million people selected policies or were auto-enrolled into coverage on the federal exchange, according to the Centers for Medicare & Medicaid Services. That’s down slightly from the 8.5 million people who signed up in 2019 for coverage.
The number of new sign ups held fairly steady after dropping a year ago. The number of people renewing coverage slipped a little.
The data covers all but the last few hours of the open enrollment period — which had to be extended because of technical problems on the final day of enrollment, December 15 — for the 38 states that use healthcare.gov. Also, it does not include sign ups from Nevada, which created a state-based exchange this year. Last year, some 84,000 Nevada residents selected 2019 policies on the federal exchange.
The figure also does not include sign ups on the state-based exchanges, some of which have longer open enrollment periods. The final tally likely won’t be available until February or March.
Sign ups on the federal exchange have been declining slowly, but steadily, since President Donald Trump took office in 2017 and vowed to overturn the landmark health reform law. He slashed the open enrollment period in half, cut the advertising budget by 90% and severely curtailed funding for enrollment assistance.
Some 9.2 million people picked policies during open enrollment for 2017 coverage, which ran until January 30 of that year.
For 2020, the average premium for the benchmark plan dropped 4% — the second year in a row of lower rates — while 20 more insurers are offering policies, bringing the total to 175. While the Trump administration is claiming credit for stabilizing the exchanges, industry experts say insurers have raised rates high enough in recent years to make selling plans on the exchanges a profitable business. A dozen states have also instituted “reinsurance” plans, which help reduce premiums because they shield insurers from high-cost patients.
Last week, former President Barack Obama released his now-annual video to spur people to sign up for Obamacare before the deadline. This year’s theme was the former President’s holiday shopping list of gifts for $10 or less — which, he said, includes health care coverage.
Obama called attention to the fact that two-thirds of those with coverage on federal exchange, healthcare.gov, can find 2020 plans with monthly premiums of $10 or less thanks to premium subsidies.
Sign ups were stronger in several states that run their own exchange. Maryland reported that nearly 159,000 residents enrolled for 2020, the largest number in four years.
In California, which now provides additional state-funded subsidies to certain middle-income residents, nearly 1.4 million people signed up. This includes 230,000 new consumers, an increase of about 16% from last year. Californians have until the end of January to select 2020 coverage.
“In the past week, Covered California saw thousands of people come through its doors, with the majority receiving new financial help from the state, from federal tax credits, or from both,” said Peter Lee, executive director of the state-based exchange.
The federal enrollment report comes two days after a federal appeals court upheld a lower court ruling declaring the individual mandate unconstitutional, but sent the law back to the district court to consider whether the mandate can be separated from the rest of the Affordable Care Act.
The law remains in effect while the case works its way through the court system.