Obamacare Sign-Ups in Texas Dipped More Than the National Average Last Year

Two Californians wait to meet with an enrollment counselor to sign up for Affordable Care Act insurance in Sacramento. Nationwide enrollments are holding up despite uncertainties about the health law's future

The data, released Wednesday, provides the first look at sign-ups for 2018 nationwide.

In fact, of the 12 jurisdictions running their own exchanges, eight gained enrollees - only California, the District of Columbia, Maryland and Vermont lagged behind 2017 levels.

The latest open enrollment period was indeed unlike any other saw far in the ACA's history, as it was not only half as long for many states but also taking place after a year in which Congress tried repeatedly to repeal the law that created the individual marketplaces. Also, insurers hiked premiums for many plans amid the uncertainty in Washington, D.C. and President Trump's elimination of funding for Obamacare's cost-sharing subsidies. If they prove popular, that could siphon off more healthy people.

The modest dip in sign-ups shows the importance of the Affordable Care Act to consumers, advocates argue. Only 11 states plus Washington D.C. have their own exchanges, but the state-specific marketplaces spurred those states to level sign-ups previous year.

Still, the burden of higher premiums would fall on the 6 million or so people who buy their own insurance but don't get a federal tax credit to help them purchase coverage, according to an earlier study done by Covered California.

Although fewer people signed up for coverage through the state's insurance marketplace, more than 50,000 new consumers selected a plan during the final three days of open enrollment.

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But in a marked contrast, two-thirds of the marketplaces run by states instead of the federal government saw increased enrollment between 2017 and 2018, including CT and NY. That's 3% less than a year ago.

Even bigger enrollment increases were recorded in Washington state, which had 7.6 percent increase, and Rhode Island, which led all states with a 12.1 percent increase. Covered California Director Peter Lee attributed some of that to efforts by the state to encourage off-market purchases by consumers who don't qualify for subsidies.

The annual enrollment tally remains a relatively crude metric that doesn't account for what kind of consumers are signing up for coverage. The outlook for next year is dicey.

In 2018, most of the 39 states that rely on the U.S. Department of Health and Human Services to operate their markets saw small decreases compared to 2017, the data show.

While Republicans in Congress have largely moved away from trying to repeal and replace Obamacare after their efforts failed past year, the Trump administration continues to chip away at the law.

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