Trump touts Obamacare death knell, arrives to Florida sign-up surge

Dec. 22--President Donald Trump said killing the penalty for lacking health insurance essentially repeals Obamacare, only to arrive in Florida where an unexpected 1.7 million signed up for 2018 plans in half the usual time.

"Hearing that we matched last year's total of 1.7 million Floridians is amazing," said Jodi Ray, project director for enrollment-promotion group Covering Florida, on Friday.

And it's not quite over in the state with the most enrollees in the federal marketplace. Florida residents can still sign up through Dec. 31 because of an extension related to Hurricane Irma.

Nationally, 8.8 million enrollment for 2018 comes in not far from last year's 9.2 million in half the time to sign up, which Affordable Care Act supporters called a stunning rebuke to administration efforts to smother the health law.

In October, Trump said, "Obamacare is finished. It's dead. It's gone."

Ray said it "proves not just how hard everyone worked to help as many consumers as feasibly possible, but just how great the need is and the personal desire to have health-care coverage is to Floridians and Americans across the country."

The Trump administration trimmed the enrollment window in half to six weeks ending Dec. 15 and reduced the advertising budget 90 percent.

This week, the president said he believes the health law is essentially repealed because the tax bill that just became law removes the penalty for not having insurance, which starts at $695.

"When the individual mandate is being repealed, that means Obamacare is repealed," Trump said Wednesday.

"We didn't want to bring it up," Trump said. "I told people specifically be quiet with the fake news media because I don't want them talking too much about it."

It's possible that will still have a significant future effect on the Affordable Care Act marketplace. The penalty is removed starting in 2019, analysts say, so it's still on the books for 2018. It remains to be seen if that influences some insurance companies to pull out in 2019, or even affects some on-the-fence customers who signed up for 2018 but could be tempted to peel off if they think the penalty won't really be enforced in the meantime.

Congressional budget analysts projected that if fewer healthy people sign up, it could raise premiums for remaining buyers about 10 percent.

Then again, the vast majority of Obamacare's remaining customers are receiving government subsidies to reduce the cost of insurance -- so their out-of-pocket costs change very little despite headline premium increases. Monthly premiums remain less than $100 for most in Florida.

So for many who want insurance at all, it's still a better deal than they can find if they are not already covered by an affordable employer's plan or a government plan like Medicare. The people not getting a good deal are those making too much income to qualify for subsidies, about $48,000 for individuals or $97,000 for a family of four, though some insurers have tried to craft off-market plans to appeal to those buyers.

Seema Verma, head of the Centers for Medicare and Medicaid Services, said the results just prove the Trump administration administered the law more efficiently.

"This year CMS took a more cost-effective outreach approach, spending just over $1 per enrollee on outreach and education for Exchange coverage compared to nearly $11 per enrollee last year," Verma tweeted.

She added, "In a market that is experiencing soaring rates, I am proud of the hard work CMS put into making sure that our customers didn't experience the website failures that were commonplace with http://HealthCare.gov in previous open enrollment periods."

Affordable Care Act supporters said the enrollment numbers came in spite of the administration's best efforts to dampen participation.

"There is no reasonable justification for the administration cutting in half the time families had to enroll in coverage and slashing outreach to families," said Frederick Isasi, executive director of pro-ACA group Families USA.

His group says consumers set a new record for weekly enrollment Dec. 10 to Dec. 15, when 4.1 million people selected health insurance plans on HealthCare.gov. Previous high: 4 million signing up during the week of Dec. 13 to Dec. 19, 2015.

Isasi said despite the reduced sign-up window, despite "slashing funding to provide in-person enrollment assistance, redirecting outreach money, shutting down HealthCare.gov on Sundays, and reducing the advertising budget by a startling 90 percent -- families from across the nation overcame the hurdles put in their way and signed up for coverage at an unprecedented pace."

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