Fewer people have enrolled in health care plans through the HealthCare.gov website this year, with sign-ups down by 11 percent compared to the same period in 2017. Margot Sanger-Katz and Reed Abelson of The New York Times reviewed some of the potential reasons for falling enrollment:
* The individual mandate has been eliminated: The GOP tax bill reduced the penalty for not having insurance to zero, removing a financial incentive to sign up for health care. Public awareness of this change is low, however, so it’s not clear what effect the change is having.
* Cheaper alternatives are available: After receiving approval from the Trump administration, less expensive health plans that don’t meet the robust requirements of the Affordable Care Act are now being sold.
* Medicaid expansion: Virginia has expanded its Medicaid program, and the state has seen the biggest decline in Obamacare enrollment as some residents switch providers.
* More jobs: Low unemployment means more people have access to work-based health care plans.
* Higher prices: Although sticker prices largely held steady for 2019 plans, subsidies fell in some places as well, raising the final price for some participants. More competition between insurers resulted in a reduction in the number of zero-cost plans.
* The word isn’t getting out: The Trump administration slashed the promotional budget by 90 percent, so there’s far less advertising than a few years ago. There is also less news coverage.
The enrollment period ends on December 15. While there’s typically a surge of people signing up at the last minute, most experts expect enrollment to remain at the lower level seen so far this year.