Enrollment was reportedly down 20% for the 2019 enrollment period.
The enrollment period for the ACA’s Federal program ended on December 15 with enrollment numbers taking a precipitous dive over years previous. The Centers for Medicare and Medicaid Services reported an enrollment dip of 20% in 2018. Why the dip? Several reasons.
Smaller Marketing Budget
As the ACA program is still in its infancy, it relies on marketing to encourage enrollment. Signing up for insurance is fairly confusing. Enrollees needs to know where to go, an explanation of costs and benefits and the enrollment deadline date. Last year, the Trump administration shortened the enrollment period from end of January to December 15th. Kaiser Family Foundation reported that many insurance customers where unaware of this year’s deadline date.
The Trump administration cut the overall marketing budget for the 2017 program by 90%. The budget remained at those cut levels in 2018. Part of the cut budget were insurance navigators, or individuals that help explain ACA options to enrollees.
Elimination of the Mandate
A big reason for the reduction in ACA enrollment is the removal of the individual penalty for people without insurance, effective January 1, 2019. It’s likely many enrollees in previous years were motivated to purchase insurance solely to avoid the penalty.
Emergence of Skinny Plans
This year the Trump Administration allowed low cost, short term, bare bones health plans, also known as skinny plans. These plans are engineered for the price conscious insurance consumer. They have been the subject of much criticism for omitting some of the most basic coverage, such as prescription drug benefits.
The U.S. economy has been in a long period of prosperity with unemployment numbers sinking below 4%. As more people are gaining health coverage through their employers, less are shopping in the ACA marketplace.