Fewer people selected health insurance plans this year on Colorado’s Obamacare exchange, the first time open enrollment numbers have dropped year-over-year in the state and in keeping with a nationwide dip in people buying insurance on such exchanges.
Colorado health care advocates said the decline may in part be due to recent decisions by the Trump administration to chip away at provisions of Obamacare, officially known as the Affordable Care Act. But the overall reason for the decline is unclear. Also unclear is whether there are now more people without health insurance in Colorado.
Through Friday, when open enrollment on Connect for Health Colorado closed, 165,777 Coloradans had selected a health plan on the exchange. That is a nearly 4 percent decline from last year, when 172,361 bought a plan. The most recent open enrollment period, which began in the fall, was 22 days shorter than the previous period.
Despite the drop, Connect for Health Colorado CEO Kevin Patterson said he is happy with the number.
“These are positive results that show us holding steady and in line with our targets for the year,” Patterson said in a statement. “Despite the uncertainty that created some confusion in the market, we have seen volumes that nearly match last year’s longer Open Enrollment Period.”
Connect for Health Colorado is where Coloradans who buy health insurance on their own go to shop for plans and receive tax credits provided by Obamacare. Only about 8 percent of Coloradans buy insurance through the individual market, compared with about half who receive insurance through their employers. But enrollment on the exchange is watched closely as a marker of Obamacare’s health.
In the past year, the law has seen significant turmoil. The Trump administration announced that it would not fund payments designed to bring down the cost of coverage, causing insurance companies in Colorado to raise premiums even higher than their already proposed double-digit-percent increases. The GOP-backed tax bill that President Donald Trump signed into law contained a repeal, beginning in 2019, of the fine that people must pay for not having health insurance.
On the federal HealthCare.gov exchange — used by more than 30 states that, unlike Colorado, have not set up their own exchanges — the Trump administration slashed the advertising budget and shortened the open enrollment period. The result was 500,000 fewer people this year selecting a plan on HealthCare.gov, a drop of more than 5 percent.
Because Colorado has its own exchange, the state had a longer open enrollment window and more robust advertising. Adam Fox, who is with the Colorado Consumer Health Initiative, said that flexibility helped Colorado prevent deeper losses.
“It’s encouraging that our state-based marketplace continues to perform well despite all the chaos and uncertainty that’s been created at the federal level,” he said.
Fox said premium increases for plans on the exchange — which ultimately averaged nearly 33 percent — may have driven some consumers out of the market. But the numbers released Tuesday only reflect enrollment through the exchange. People who are not eligible for a tax credit to help pay their premiums can also shop for plans through a private broker.
Joe Hanel, a spokesman for the nonpartisan Colorado Health Institute, said it is also possible that more people gained coverage through an employer, lessening the need to buy on the exchange.
As a result, it is not clear whether the drop in enrollment on the exchange means an increase in the uninsured in Colorado. Nationally, a Gallup poll released Tuesday estimated that 3.2 million more Americans were uninsured at the start of 2018 compared with the start of 2017. But a good look at Colorado’s uninsured rate won’t come until 2019, when the Colorado Health Institute releases its next major survey on health care access.
Overall, Hanel said he was surprised at Connect for Health Colorado’s sign-up numbers, given the headwinds.
“It’s impressive that as many people enrolled as did,” he said.
