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Despite Trump's attacks, Obamacare sign-ups dip only slightly

Despite the Trump administration's repeated attacks on Obamacare, millions of Americans opted to sign up for coverage...

Posted: Feb 8, 2018 5:25 AM
Updated: Feb 8, 2018 5:25 AM

Despite the Trump administration's repeated attacks on Obamacare, millions of Americans opted to sign up for coverage on the exchanges for 2018 anyway.

Some 11.8 million people selected plans on the federal and state-based exchanges, down 3.7% from last year, according to the National Academy for State Health Policy. The data, released Wednesday, provides the first look at sign-ups for 2018 nationwide.

Just over 8.7 million people signed up on the federal exchange, while a little over 3 million picked plans in the 11 states and District of Columbia, which run their own marketplaces.

Obamacare advocates had feared that sign-ups would plummet after the Trump administration cut the open enrollment period in half, slashed advertising by 90% and reduced support for enrollment assistance. Also, insurers hiked premiums for many plans amid the uncertainty in Washington, D.C. and President Trump's elimination of funding for Obamacare's cost-sharing subsidies. However, in a strange twist, richer federal premium subsidies actually made coverage more affordable for many people.

Related: 8 ways Trump hurt Obamacare in his first year

The modest dip in sign-ups shows the importance of the Affordable Care Act to consumers, advocates argue.

The academy's figures provide the initial evaluation of how enrollment fared in the state-based exchanges, which have more control over their outreach efforts and enrollment schedules. Several states extended their season into January, with California and New York allowing people to select plans until the end of the month.

Sign-ups fell 5.3% in the 34 states that leave enrollment entirely to the federal exchange, healthcare.gov. But it remained essentially flat in the 12 state-based marketplaces and in the five states that have their own exchanges, but outsource the enrollment process to healthcare.gov.

The Centers for Medicare and Medicaid Services is expected to release its comprehensive review of 2018's open enrollment period in coming weeks. Enrollment isn't final until consumers pay their first month's premium.

Related: Mike Pence's home state can now require Medicaid recipients to work

Several state exchange directors said Wednesday that their robust marketing and outreach efforts helped to keep sign-ups even or ahead of last year's. The standouts included Rhode Island, which saw a 12.1% increase, and Washington, which had 7.7% more people pick plans.

Only four states -- California, Idaho, Maryland and Vermont -- saw sign-ups slip.

Peter Lee, executive director of the Covered California exchange, said one reason why its numbers fell 2.3% is because it encouraged residents who don't qualify for premium subsidies to buy coverage off the exchange, where rates were cheaper for some plans. He highlighted that nearly 390,000 new consumers signed up for coverage, an increase of 5% over the prior year.

Related: Millions more Americans were uninsured in 2017

While the state exchange directors said Obamacare remained strong this year, they were concerned about Congress' elimination of the individual mandate starting in 2019. A central pillar of the health reform law, the mandate requires nearly all Americans to get coverage or pay a penalty.

"While we've seen remarkable stability in 2018, 2019 looks very troubling," Lee said, noting that premiums could rise by 30% in some states.

While Republicans in Congress have largely moved away from trying to repeal and replace Obamacare after their efforts failed last year, the Trump administration continues to chip away at the law. It is in the process of relaxing federal regulations to allow the sale of more insurance policies that don't adhere to Obamacare's mandates, for instance.

Mississippi Coronavirus Cases

Data is updated nightly.

Cases: 259117

Reported Deaths: 5668
CountyCasesDeaths
DeSoto17436187
Hinds16524328
Harrison13876199
Rankin11000217
Jackson10652187
Lee8981141
Madison8413168
Jones6552112
Forrest6101121
Lauderdale6034189
Lowndes5463119
Lafayette507393
Lamar496465
Washington4877124
Bolivar4068109
Oktibbeha401681
Panola378380
Pontotoc372155
Monroe3628105
Warren3619101
Union350563
Marshall349569
Neshoba3433152
Pearl River3380104
Leflore3079108
Lincoln300687
Sunflower289272
Hancock285360
Tate276762
Alcorn268854
Pike266580
Itawamba266261
Scott253448
Yazoo250156
Prentiss249552
Tippah245850
Copiah244549
Coahoma243654
Simpson240069
Leake234367
Grenada221171
Marion218473
Covington216972
Adams210170
Wayne206432
Winston205267
George202739
Attala195761
Newton195745
Tishomingo192461
Chickasaw186144
Jasper176038
Holmes169868
Clay162735
Tallahatchie154935
Stone148424
Clarke143562
Calhoun138021
Smith125825
Yalobusha120234
Walthall113437
Greene112129
Noxubee111425
Montgomery110936
Carroll105922
Lawrence104317
Perry103231
Amite99926
Webster94324
Tunica87621
Jefferson Davis87327
Claiborne86825
Benton84023
Humphreys83624
Kemper79120
Quitman7029
Franklin68716
Choctaw62313
Wilkinson58825
Jefferson55920
Sharkey44217
Issaquena1606
Unassigned00

Alabama Coronavirus Cases

Cases: 432536

Reported Deaths: 6379
CountyCasesDeaths
Jefferson63523957
Mobile30967562
Madison27627201
Tuscaloosa21122268
Montgomery19495326
Shelby18941126
Baldwin16798188
Lee12901102
Morgan12447129
Etowah11911178
Calhoun11365205
Marshall10322119
Houston8813156
Limestone823176
Cullman8159106
Elmore8056104
DeKalb7796102
Lauderdale773399
St. Clair7705122
Talladega6347109
Walker5993174
Jackson590341
Colbert543274
Blount541186
Autauga527061
Coffee454160
Dale405482
Franklin371948
Russell345712
Chilton340972
Covington334168
Escambia328344
Dallas310196
Chambers297370
Clarke290536
Tallapoosa2665107
Pike258830
Marion250155
Lawrence249150
Winston231442
Bibb219848
Geneva206946
Marengo205229
Pickens198631
Hale180842
Barbour177836
Fayette174528
Butler171358
Cherokee162530
Henry157523
Monroe150718
Randolph143236
Washington139527
Clay128546
Crenshaw121644
Cleburne119724
Lamar119621
Macon119637
Lowndes112536
Wilcox105822
Bullock101428
Perry99118
Conecuh96320
Sumter89726
Greene76723
Coosa62215
Choctaw51624
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