Texans have signed up for health insurance under the Affordable Care Act in high numbers through the initial four weeks of open enrollment, with applications so far up by more than 50 percent in the state — but a significantly shortened enrollment period means the final count still might fall below last year.
Nationally, enrollment on the federal health care exchange is up by about 30 percent so far, to 2.78 million this year from 2.14 million last year, according to the federal Centers for Medicare and Medicaid Services, which released the figures Wednesday for the first four weeks of the open enrollment period that began Nov. 1. The figures don’t include people automatically re-enrolled in their insurance plans, and they don’t include those signing up in states that operate their own exchanges.
A number of factors appear to be driving the higher numbers, including the availability of larger subsidies that have made some insurance plans cheaper for consumers, as well as widespread publicity surrounding the Affordable Care Act this year as Republicans repeatedly tried and failed to kill it.
“This has been in the news so much — even though some of (the rhetoric) has been negative with the Trump administration talking about rising premiums and other issues, it still has been in the headlines,” said Jennifer Tolbert, director of state health reform at the Kaiser Family Foundation in Washington. “So I think perhaps more people are aware of it.”
The shortened enrollment period this year also appears to have spurred more people to sign up earlier, observers said. In Texas specifically, the state’s relatively high rate of uninsured residents could be playing a role as well by prompting people to sign up amid fears that it could be their last chance in case the Affordable Care Act is repealed.
“We have more uninsured people in this state, and I think that is perhaps part of” the reason for this year’s high Texas enrollment figures so far, said Kay Ghahremani, chief executive of the Texas Association of Community Health Plans. “It is certainly not what everyone expected, but I think it is a testament to the value that people put on (health) insurance.”
Enrollment for 2018 insurance under the Affordable Care Act — also known as Obamacare — began Nov. 1 and runs through Dec. 15, for a total of slightly more than six weeks. Last year, the enrollment period lasted three months.
The United Way for Greater Austin, with support from Central Health, is providing a call center for information and assistance during the enrollment period. To access the service, local residents should dial 211 on their phones and then press option one.
In Texas, a total of 334,328 people signed up for insurance plans between Nov. 1 and Nov. 25 this year, compared with 220,279 between Nov. 1 and Nov. 26 last year, according to the Centers for Medicare and Medicaid Services.
County-level data isn’t available yet, but Elizabeth Colvin, director of the Insure Central Texas program at Foundation Communities, said the overall higher enrollment figures statewide and nationally is in line with what she has been seeing — although she noted the local trend appears to be even more pronounced.
Her organization, which focuses on the segment of consumers who need help enrolling or have complex medical needs, has signed up about 2,800 people so far, more than doubling the estimated 1,200 it had enrolled through the same period last year.
“It is very important that we maintain these higher numbers through Dec. 15,” Colvin said. “It is important for people to understand that we have to have this increase because we have half the time” to help people sign up.
In addition to shortening the enrollment period this year, the Trump administration cut money for an annual federal campaign to promote it by 90 percent — to $10 million — and reduced funding for health care navigators, organizations that educate people about their insurance choices and help them sign up.
Funding for Texas navigators was cut by 34 percent this year — to $6.1 million from $9.2 million last year — according to the Kaiser Family Foundation.
Collectively, the actions by the Trump administration prompted fears among Affordable Care Act proponents that enrollment would suffer this year. While the numbers are trending up after four weeks, it will take a major surge in the final stretch of open enrollment to match last year’s figures that were compiled over a three-month period.
Nationally, 9.2 million people signed up for insurance plans on the federal exchange during open enrollment last year. A total of about 1.23 million signed up in Texas, according to the Centers for Medicare and Medicaid Services, while about 114,000 signed up in the Austin metro area.
Colvin declined to predict if the final figures this year can match last year’s enrollment, saying her group’s focus “is on getting as many people enrolled as possible” in the final two weeks.
“We still have a chance to get there,” she said.
“There needs to be a pretty sizable surge in the remaining two weeks in order for enrollment to reach the same levels as last year,” Tolbert said. “It will be challenging, but I don’t think impossible.”
BY THE NUMBERS
2017 Affordable Care Act sign-ups*
• Texas enrollees this year: 334,328
• Texas enrollees last year: 220,379
• Texas percentage increase: 52 percent
• U.S. enrollees this year: 2.78 million
• U.S. enrollees last year: 2.14 million
• U.S. percentage increase: 30 percent
*Through four weeks
Source: Centers for Medicare and Medicaid Services