More Texans signed up for health insurance under the Affordable Care Act during the open enrollment period this year than in 2018, despite the state's leading role in a high-profile court battle to dismantle it.
Enrollment statewide totaled nearly 1.12 million people during the sign-up period for 2020 insurance plans that ended last week, according to the federal Centers for Medicare and Medicaid Services. The figure marked an increase of about 30,000, or 2.5%, from 1.09 million who signed up or automatically re-enrolled last year for 2019 plans.
Nationally, enrollment slipped about 1.7%, to 8.3 million, among states that use the federal HealthCare.gov marketplace, which includes Texas. The Centers for Medicare and Medicaid Services called the figures stable overall, however, noting among other things that 38 states opted to use the federal exchange this year, compared to 39 last year, because Nevada transitioned to its own exchange.
The federal agency has yet to release county-level enrollment data. But Austin-area health care advocates said demand for 2020 health insurance plans under the Affordable Care Act -- also known as Obamacare -- appeared to be solid.
"We were able to reach more uninsured people this year" and help them sign up, said Kori Hattemer, who oversees financial programs for local nonprofit Foundation Communities. "That's a big measure of success."
Hattemer said her organization's total enrollment of about 4,700 this year was down from slightly more than 5,000 last year
A higher percentage who sought enrollment help from Foundation Communities this year previously had no health insurance, she said, while some repeat clients from prior years now felt comfortable signing up for new plans themselves or opting for automatic re-enrollment. In addition, she said, the strong economy likely gave more people the option of employee-sponsored health insurance.
Wesley Durkalski, CEO of Sendero Health Plans, a nonprofit offshoot of Travis County's Central Health agency, called open enrollment this year relatively strong as well. Sendero, which had about 14,000 people enroll in its ACA-compliant health plans last year, said in a written statement that results are still being tabulated but "it appears we ended open enrollment with more members than when we started."
As in previous open enrollment periods, some health care advocates said they feared that Republican attacks on the Affordable Care Act -- a signature achievement of former Democratic President Barack Obama -- would lead to fewer sign-ups.
"It would seem to me overall that the Affordable Care Act has emerged bruised but not broken," U.S. Rep. Lloyd Doggett, D-Austin, said in an interview Monday about the latest enrollment figures. "I'm pleased to see that there is still a strong demand for the protections that it provides."
But Doggett criticized Republican leaders in Texas and elsewhere for continuing to work to undermine the law that millions of people depend upon without unveiling a replacement. The effort is particularly egregious in Texas, he said, which has the highest rate of people without health insurance in the country and is "the uninsured capital of America."
Texas Attorney General Ken Paxton, who is at the helm of a coalition of Republican-led states in an ongoing legal battle to eliminate the law, heralded a ruling last week by a federal appeals court that partially sided with him and other GOP critics. Paxton called the ruling "a win for the rule of law" in a written statement and said scrapping the ACA "will be a victory for all Americans."
The ruling by a three-judge panel of the 5th U.S. Circuit Court of Appeals in New Orleans, found the ACA's individual mandate requiring all Americans to have health insurance to be unconstitutional. The appeals court put off a decision on whether to invalidate the rest of the law by ordering a lower court to reconsider the question.
"I look forward to demonstrating in district court that the rest of the law cannot stand without this central provision," Paxton said, referring to the individual mandate.
The appeals court ruling will have no impact on 2020 health plans or medical coverage, according to Seema Verma, administrator of the Centers for Medicare and Medicaid Service, and many observers expect the fate of the Affordable Care Act ultimately to be decided by the U.S. Supreme Court.
Doggett said that means "health care is definitely on the ballot in 2020," saying he thinks the Supreme Court is likely to invalidate the Affordable Care Act eventually. The law isn't perfect, he said, but should be fixed instead of overturned.
"In 2021, we have a big job in how do we strengthen it (and) how do we expand it," Doggett said.
During open enrollment last year, about 85,000 people in Travis, Williamson, Hays, Bastrop, Caldwell and Burnet counties signed up for 2019 coverage on the federal HealthCare.gov marketplace. Enrollment in Travis County came in at 53,309, while Williamson County sign-ups totaled 19,447.
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