Experts Predict Fewer ACA Enrollees Nationwide

Nov. 01--Health-care experts project the Trump administration's efforts to destabilize Obamacare will lead to fewer enrollees nationwide during the health-insurance enrollment period that begins Wednesday, but New York and other states extending their enrollment periods may prove to be exceptions.

The Trump administration recently cut the federal open enrollment period in half, to six weeks from three months. Now, most Americans seeking coverage through Obamacare, those not insured through their employers or Medicare, will have from Wednesday until Dec. 15, to enroll for 2018.

The federal government also plans to curtail the signup period by closing the online marketplace, healthcare.gov, for 12 hours of maintenance nearly every Sunday during open enrollment.

But the 12 states that operate their own health-insurance exchanges have the power to extend their enrollment periods beyond Dec. 15. Nine states, including New York, have done so. New York's will last until Jan. 31.

Though state officials don't project how many will enroll next year, the Empire State has seen robust Obamacare enrollment of nearly 4.1 million this year, up nearly 13 percent from the year prior, including almost 2.84 million Medicaid enrollees and non-Medicaid enrollment of more than 1.25 million.

As of early October, local Obamacare enrollment totaled 91,580 in Orange County, 20,750 in Sullivan County and 35,865 in Ulster County. State officials expect enrollment to remain healthy in 2018.

"Despite the ongoing debate in Washington over the future of the Affordable Care Act, New York's marketplace remains open and strong as ever," said the state's health insurance exchange leader, Donna Frescatore, executive director of NY State of Health, in a statement.

New York's enrollment success has come despite an executive-branch strategy President Donald Trump has called: "Let Obamacare implode, then deal."

The president has said hurting the law could force Democrats to negotiate to replace a bill that experts and politicians across the aisle agree has improved insurance accessibility while struggling to address affordability.

This year, the Trump administration has slashed enrollment promotional funding by 90 percent, to $10 million from $100 million, while cutting grants for groups that help people enroll to $36 million from $63 million. The federal exchange's former marketing director estimated the latter move alone could lead to a loss of 1.1 million enrollees nationwide.

"The president is obviously trying to sabotage Obamacare, and no one is even pretending otherwise," Congressman Sean Patrick Maloney said via email. "What's getting lost is that real live human beings are going to get hurt by the president's cynical games. If the president ever decides he actually wants to make this law work better for people, I'm ready to work together. In the meantime, I say, do your damn job."

The president also recently eliminated cost-sharing-reduction payments. Those federal reimbursements to insurers reduce the deductibles, co-payments and other out-of-pocket costs, making health coverage more affordable. Earlier this month, New York Attorney General Eric Schneiderman announced a multi-state lawsuit with 19 other attorneys general to defend the subsidies.

"'Sabotage' is an accurate description of how the Trump administration has tried to undermine the law," said Jeff Maclin, a spokesman for the Community Service Society, a statewide anti-poverty and health-care advocacy group. "Contrast that with what's going on in New York, and you see a strong (Obamacare) program, organizations that help people enroll at the local level and a one-stop shopping marketplace."

daxelrod@th-record.com

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