Obamacare Signups Decline as Democrats Blame Lawsuit, Trump

  • HealthCare.gov enrollments fall by 300,000 for 2019
  • Judge ruling overturning ACA caused confusion,critics say

Enrollment on Obamacare’s federal marketplace fell for the second straight year, but the Trump administration declared the signup period another success.

Roughly 8.5 million people enrolled for health insurance via the federal marketplace, Healthcare.gov, for 2019, a 4 percent decline from the previous year, according to preliminary figures. The drop is expected to buttress Democrats’ argument that the Trump administration has been a poor steward of the Affordable Care Act.

Joe Raedle/Getty Images
The budget has been cut for Obamacare enrollment assistance.

Congressional Democrats Dec. 19 predicted enrollment would decline partly because a federal judge in Texas declared the health law unconstitutional on the second-to-last day of open enrollment. Some lawmakers said they heard from people who assumed their insurance would be worthless if the law were voided by a court.

“They were scared to death,” Sen. Joe Manchin (D-W.Va.) told reporters.

U.S. District Judge Reed O’Connor‘s decision didn’t immediately affect the law and his ruling is slated to be appealed.

Trump administration health officials, however, said the open enrollment period was a success and called this year’s signup period “steady.”

“This Administration has taken strong steps to promote a more competitive, stable health insurance market and these steady enrollment numbers are yet another sign that the Administration’s efforts are working,” Seema Verma, administrator for the Centers for Medicare & Medicaid Services, said in a statement.


Earlier some were expecting a growth in enrollment, partly because there were more “zero-dollar” or essentially free health insurance plans for low-income Americans this year. The growth in the number of these plans was spurred by a quirk in the health law that many insurers took advantage of.

“Given stable prices, more issuers, more uninsured people, and the availability of ultra low cost $0 bronze plans, we should have seen modest growth this year at the very least,” Joshua Peck, former chief marketing officer for HealthCare.gov under the Obama administration, said in a statement.

Peck said the court ruling caused confusion, with many people believing their insurance plans might be voided.

The last day of open enrollment is typically the busiest, Peck said, with more than 500,000 typically signing up that day.

Democrats are blaming the Trump administration’s handling of the open enrollment for lagging signups on HealthCare.gov, so far this year.

The decline could have been steeper. Through the sixth week of open enrollment, signups for plans sold on the federal marketplace were down 12 percent from last year, reaching 4.1 million, according Get Covered America, a pro-ACA organization that examines federal data. That group expected an almost 800,000-person drop in sign-ups.

However, the drop was closer to 300,000.

Democrats want the Trump administration to reverse several decisions to cut funding and resources for open enrollment activities.

The Department of Health and Human Services has made changes to open enrollment, cutting the budget for marketing and outreach to $10 million in 2018, down from the roughly $100 million spent during the last year of Barack Obama’s presidency. The agency also slashed funding for navigators, groups that help people purchase insurance plans, to just about $10 million this year, compared with $63 million in 2016.

Some experts are still cautioning that the figures released by the Centers for Medicare & Medicaid Services Dec. 19 may not give a full picture of the nation’s insurance markets.

One single element can’t be blamed for the change in enrollment numbers, Elizabeth Carpenter, a senior vice president at Washington-based health-care policy consulting firm Avalere Health.

“It would be hard to imagine that there’s no one that was confused out there, but it’s hard to say exactly how many people,” she said.

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bgov.com