By Juliet Eilperin and Amy Goldstein / The Washington Post
WASHINGTON — More than 600,000 Americans signed up for insurance coverage under the Affordable Care Act during the first four days of the new enrollment season, according to numbers released Thursday by federal officials that signal a brisk start despite Republicans’ efforts to dismantle the law.
A total of 601,462 Americans chose a health plan from Nov. 1-4 in states relying on the federal exchange, the figures from the Centers for Medicare and Medicaid Services show. More than one in five — 137,322 — were new enrollees.
While CMS officials did not release a direct comparison with any of the four previous enrollment periods, administration officials who spoke on the condition of anonymity said that more than 200,000 consumers selected plans on the first day, more than double the number last year.
Just over 1 million Americans signed up on the federal exchange during the first 12 days of open enrollment in 2016.
But the initial federal figures suggest that the proportion of newcomers to the ACA marketplaces continues to decline. The 22 percent of new enrollees during the first four days in November compares with 24 percent in the early days of 2016 and 33 percent in 2015.
The CMS data only reflect sign-ups in the three dozen states that rely on HealthCare.gov, the federal enrollment website. But the apparent uptick there has been mirrored in states that run their own ACA marketplaces. The vast majority of those exchanges — including California, Colorado, Connecticut, the District of Columbia, Idaho, Maryland, New York, Rhode Island and Washington — all report an increase in both enrollment and inquiries at their call centers.
Taken together, the early figures show that efforts by President Donald Trump and congressional Republicans to undo much of the 2010 law have not dampened consumers’ willingness to turn to the insurance marketplaces it created. Another factor in the faster pace could be that the enrollment season lasts until only mid-December – half as long as in past three years.
Unlike during those years, when President Barack Obama urged Americans to buy coverage and the federal government heavily subsidized both advertising and in-person assistance for consumers, federal officials have done little to promote ACA enrollment. The Health and Human Services Department cut the federal advertising budget by 90 percent, cut funding to those assisting consumers with finding plans and shifted the government’s messaging.
ACA supporters said they cannot point to a single reason for why more people are renewing coverage early or signing up for the first time.
“We are happy to report heavy traffic across the state, in rural and urban areas,” Jennifer Simmons, navigation program coordinator for the North Carolina Navigator Consortium, said in an email. “Consumers are, generally speaking, expressing urgency with getting this task taken care of and off their to-do list.”
But other state officials and health-care advocates have expressed concern about whether rural consumers, who often do not have as ready an access to in-person assistance, will end up not getting covered this year.
Jessie Menkens, who helps oversee statewide enrollment efforts as the Alaska Primary Care Association’s navigator program coordinator, said in an email that while assisters have seen “steady interest in the Anchorage area,” enrollment in the state’s vast rural areas “was much slower than past open enrollment periods — this is concerning news.”
Though premium rates for 2018 have dropped an average of 21 percent there, “many Alaskans still don’t know about the reduction in insurance costs, and they remain confused about [the law], given current events and marketing reductions,” she added.
In releasing the HealthCare.gov numbers, CMS spokesman Johnathan Monroe said that direct comparisons were not possible because enrollments are typically measured from Sunday through Saturday — giving a four-day span since Nov. 1 fell on a Wednesday this year.
“Consistent with our aim to have a seamless open enrollment experience for consumers this year,” Monroe added, “the website performed optimally and consumers easily accessed enrollment tools to compare plans and prices during the first week of open enrollment.”