Obamacare enrollment could fall millions short for 2018

What you need to know about Obamacare 2018
What you need to know about Obamacare 2018

Nearly 2.8 million people have signed up for 2018 Obamacare policies on the federal exchange during the first 25 days of enrollment season.

That's quite a bit more than at this point in prior periods. Last year, 2.1 million people signed up in the first 26 days.

While those numbers may seem to bode well for the future of the health reform law, it depends on how you look at it.

True, an average of 111,300 have signed up each day this season, compared to 82,200 a year ago and 72,900 two years ago, according to data crunched by Get America Covered, which aims to promote Obamacare open enrollment.

"Enrollment continues to outpace previous years," said Lori Lodes, a former Obama administration official who co-founded Get America Covered.

Another plus: The exchanges are attracting many new customers. Some 718,300 of those who signed up so far are new, compared to 519,500 last year. The rest are returning enrollees.

All but one of the 39 states in the federal exchange saw enrollment growth. Some 53% more residents in Maine have picked plans, while 52% more Texans and Wyoming residents have signed up. Only West Virginia saw a drop -- of 1%.

Several states that run their own exchanges are also reporting increased interest. For instance, the Washington Health Benefit Exchange on Wednesday reported a 43% jump in new sign-ups and an 18% uptick in traffic through first four weeks of open enrollment. In New York, enrollment is outpacing last year by about 13%, with more than 140,000 consumers picking Obamacare plans and nearly 700,000 signing up for essential plans (for moderate-income residents) in the first four weeks.

All this is good news for Obamacare supporters, who say that the law is essential for and remains popular among millions of Americans despite President Trump and Congressional Republicans' vows to repeal it.

Related: Obamacare shoppers find fewer insurer choices on exchanges

But the picture is not as rosy if one considers that the open enrollment period is a little more than halfway over.

The Trump administration slashed the enrollment season so most people only have until Dec. 15 to pick plans, rather than the three months or more they had in previous years. (Some state-based exchanges have extended the period to as late as Jan. 30.)

That means the pace will have to pick up substantially to come close to the 9.2 million who signed up on the federal exchange by the end of open enrollment for 2017. (Another 3 million people picked plans through the state-based exchanges.)

Even Lodes acknowledged that in her assessment on Wednesday.

"Another solid week for enrollment but we need it to pick up the pace to track enrollment from last year," she said.

To be sure, many consumers wait until the last minute to enroll. So it's tough to estimate how many people will sign up in the final 20-day stretch.

The pace, however, has been slowing since the enrollment period began on Nov. 1. In the first four days, an average of 150,400 people signed up daily. Those are likely sicker Americans who really need the coverage.

Obamacare supporters worry that many other potential enrollees -- particularly the younger and healthier Americans that insurers crave and that keep premiums down -- don't realize that they have less time to sign up this year.

The administration cut the advertising budget for open enrollment by 90%, ending some of the most effective marketing tools, including television and radio spots.

Americans are noticing -- or in this case, not noticing. Some 45% said they heard less about open enrollment than they had in previous years, according to a Kaiser Family Foundation poll conducted in mid-November. Another 38% said they heard about the same amount, while 16% said they heard more.

Related: Trump's Health Secretary pick faces Senate committee

One thing that will boost the figures is that a hefty number of current enrollees will be automatically put into plans for 2018 on Dec. 16. Last year, about 2.2 million consumers were auto renewed in the federal marketplace.

Many experts expect sign ups will decline for 2018, after dipping by half a million this year.

S&P Global projected that between 10.6 million and 11.4 million people will pick plans by the end of the enrollment period. Charles Gaba, a blogger who tracks enrollment at ACASignups.net, estimates about 10 million people will sign up -- 7.5 million on the federal exchange and another 2.5 million on the state exchanges.

Consumers aren't considered enrolled until they make their first premium payment. Enrollment also varies during the year as people drop out because they find coverage elsewhere or they stop paying their premiums. Others join after losing their jobs or have other major life changes.

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