Dive Brief:
- The fourth open enrollment period for the ACA ended Tuesday with advocates reporting continued interest from consumers despite the Trump administration’s decision to pull nearly $5 million in advertising to push for last minute enrollees, according to media reports.
- The HHS declined to release any numbers but the last few days of open enrollment have traditionally been busy with high traffic on Healthcare.gov and a heavy volume of calls to support lines.
- A variety of recent surveys have shown that people are forming increasingly favorable opinions of the ACA just as Republicans in Congress are scrambling to repeal and replace the law.
Dive Insight:
This could be the last ever open enrollment period for the ACA as President Donald Trump and congressional Republicans remain steadfast in their promise to repeal the healthcare law. The decision to pull ads promoting enrollment came at a particularly damaging time: Past enrollment periods show that people, particularly the young adults crucial to the success of the law, tend to wait until the last few days to sign up.
In past years, the share of 18- to 34-year-olds in total enrollment has jumped from 31% in week 12 to nearly 38% in the final week 14, according to the CMS. Under the Obama administration, the HHS predicted 13.8 million total people signing up for the enrollment period. As of late December, the number was at about 11.5 million.
Republican leaders have more recently tempered discussion of an immediate repeal of the ACA because they are concerned about the political repercussions of taking insurance away from millions of people. Trump has put pressure on Congress for quick action, but has also said replacement of the law should happen simultaneously with repeal.
The lack of clarity over a replacement plan has made insurers uneasy. Repeal of some parts of the ACA such as the individual mandate or cost-sharing protections without any form of replacement could send the insurance markets into chaos and lead to confusion among consumers.
Meanwhile, lawmakers are watching public opinion, which has for the first time started to become more favorable toward the ACA. One key Trump constituency — lower income Republican voters — have become shifted considerably in their opinion of whether it is the federal government’s responsibility to make sure all Americans have health insurance, according to the Pew Research Center. 52% of Republican and Republican-leaning Americans making under $30,000 said in January 2016 it is the government's responsibility, which is up from just 31% in March 2016.
Whether there will be any more open enrollment periods remains up in the air as Congress debates repeal and replace — and it's unclear whether those who just signed up will be able to participate in the exchanges.