Some 195,000 Utahns signed up for health insurance under Obamacare for 2018 — nearly matching last year’s number, when the enrollment period was twice as long, the Trump administration reported Thursday.
About 130,000 people were expected to be covered in 2018 by Intermountain Healthcare SelectHealth, while University of Utah Health Plans signed up 25,000 in the six-week open enrollment period that ended Dec. 15, the insurers told The Salt Lake Tribune.
It was unclear Thursday why the enrollment numbers offered by Utah’s two remaining Obamacare insurers — for a combined 155,000 Utahns — fell significantly below the 195,000 signups that the federal Centers for Medicare and Medicaid Services (CMS) was reporting for the state.
The Affordable Care Act (ACA) enrollment period on healthcare.gov closed last Friday with a frenzy of sign-ups in the final hours, both in Utah and nationally. That pace of enrollment in Utah and elsewhere was consistently faster than last year, and in the final week, CMS reported that a total of about 90,000 Utahns joined the ranks of those insured under the ACA.
“Things ended fast and furious,” said Stacy Stanford, a policy analyst with the nonprofit Utah Health Policy Project, which helps people sign up for insurance. “We were booked solid those last few days.”
CMS said 8.8 million people signed up nationally, slightly down from 9.2 million in last year’s enrollment period, which was twice as long. And some of the national figures could go higher, as several state-run Obamacare exchanges remain open. Seema Verma, the CMS administrator, said on Twitter the agency had made the sign-up period “the smoothest experience for consumers to date.”
“In a market that is experiencing soaring rates, I am proud of the hard work CMS put into making sure that our customers didn’t experience the website failures that were commonplace with healthcare.gov in previous open enrollment periods,” Verma added in a written statement.
The strong enrollment numbers come at a precarious time for the ACA. While GOP efforts to repeal Obamacare failed this year, President Donald Trump and congressional Republicans have redoubled their efforts to undermine the law.
On top of halving the enrollment period, the Trump administration eliminated key subsidies, slashed marketing funds and assistance for insurance navigators, and opened the door for insurers to sell minimal plans that don’t meet Obamacare standards.
Another measure eroding the law came with the GOP tax overhaul bill passed Wednesday, which in 2019 removes a mandate that most Americans either sign up for health insurance or pay a penalty. Many analysts say the move is expected to further destabilize already shaky Obamacare marketplaces and put upward pressure on premiums.
“We have essentially repealed Obamacare,” Trump told reporters Wednesday after the tax overhaul’s passage in Congress.
But even as Republicans continue to roll back aspects of the law, a majority of Americans now say they support Obamacare, according to polls from the Kaiser Family Foundation, Gallup and others. And new research shows that Obamacare has resulted in fewer people delaying doctor visits or struggling to pay medical bills.
The Utah enrollment figures may still fluctuate. Molina Healthcare pulled out of the state’s insurance marketplace earlier this year, citing financial losses, so its customers have through the end of February to change their coverage. And many consumers still must pay for their plans before coverage officially kicks in for 2018, which will result in a dip in the total number of 2018 enrollees. Last year, for example, about 197,000 Utahns signed up in open enrollment — but just 172,000 ultimately paid and were covered for 2017.
The 25,000 enrollees reported by U. Health Plans make up close to five times as many people than the insurer covered this year. But the number remains well short of the U.’s projection that at least 40,000 Utahns would seek coverage through the U. in 2018, CEO Chad Westover said this week.
Officials with U. Health Plans had hoped for larger growth in their customer base after Molina’s departure — along with an expansion from offering U. plans just in counties along the Wasatch Front to all of Utah’s 29 counties.
Westover attributed the lower-than-expected numbers in part to confusion among some Molina customers, who may have thought their only choice was to switch to SelectHealth for 2018. Many Molina customers were automatically re-enrolled in SelectHealth plans for 2018 due to comparable coverage and premium levels — even though the U. Health coverage meant they could keep their doctors.
Further confusion may have stemmed, too, from a letter SelectHealth sent out to Molina’s 70,000 customers several weeks ago. As Salt Lake City’s KUTV reported, the letter indicated those customers had been automatically enrolled in a SelectHealth plan and “can simply pay up to avoid losing coverage.” A SelectHealth spokeswoman, Jamee Wright, said in an email the letter did encourage recipients to “shop the marketplace and consider their options before paying the premium.”
SelectHealth, meanwhile, boosted its Utah enrollment by roughly 30,000 customers heading into 2018. Wright said the figure was “consistent with our expectations.”
“Despite the short enrollment period, we are pleased with the efforts of our internal teams and appointed agents who helped people find plans that work best for them,” Patricia R. Richards, SelectHealth’s president and CEO, said in a written statement.
Stanford, with Utah Health Policy Project, said she had anticipated enrollment in Utah would drop by about 15 to 20 percent from last year, adding she was “blown away by the numbers we saw today” — especially considering the recent Republican efforts to “sabatoge” the law.
“The Utah marketplace is still thriving,” she said, “and it would have been even bigger and better had the enrollment period been longer.”
A new report by the nonprofit Commonwealth Fund found that thanks to the ACA, the number of uninsured Americans has fallen to record lows around the country. In 2016, 47 states including Utah saw their uninsured rates for working-age adults drop by at least 5 percentage points compared to 2013.
In Utah, the uninsured rate dropped from 18 percent in 2013 when ACA took effect to 12 percent in 2016. Utah adults who went without care due to high costs also declined, from 15 percent to 12 percent.
States that expanded Medicaid coverage to low-income adults as part of ACA provisions saw a large payoff in reducing the number of people skipping care due to cost issues and in improving access to routine care, authors of the Commonwealth Fund report said.
The 19 states like Utah that have refused to expand Medicaid could “see similar positive effects for their residents,” the report said, if they, too, expanded coverage of the program for low-income residents.
“The Affordable Care Act has put access to health care in reach for millions of Americans, particularly for people in states that embraced the law,” the report’s authors concluded.