HealthCare.gov Gets Off to a Slow Start

Federal cuts in marketing spending may have hurt HealthCare.gov performance during the first few days of the open enrollment period for 2019 health coverage.

The Centers for Medicare and Medicaid Services (CMS) says it received plan selection information for 2019 from 371,676 applicants during the first three days of the open enrollment period.

(Related: HealthCare.gov Signup Total Falls 4.5%)

About a year ago, the activity report CMS released for the first week of the open enrollment period for 2018 coverage included HealthCare.gov activity for four days.

Here’s what’s happened to HealthCare.gov first-week daily activity averages:

Applicants seeking plans: 124,892 (down 18%).
Applicants renewing coverage: 94,131 (down 19%).
Applicants applying for new coverage: 29,761 (down 13%).

What is HealthCare.gov?

Drafters of the Affordable Care Act wanted to create a family of “health insurance exchanges,” or web-based supermarkets for health coverage.

An ACA public exchange provides tax credit subsidies that people can use to pay for health insurance from private health insurers.

CMS — an arm of the U.S. Department of Health and Human Services (HHS) — set up HealthCare.gov to provide or administer ACA exchange programs in states that are unwilling or unable to run their own exchange services.

For 2019, HealthCare.gov is providing exchange plan enrollment services in 39 states.

What Is an ‘Open Enrollment Period’?

The ACA blocks health insurers from considering personal health factors other than age and location when issuing coverage, and personal health factors other than age, location and tobacco use when pricing coverage.

Regulators, insurers and ACA exchange programs have created an “open enrollment period” system, or limits on when people can buy individual major medical coverage without showing they have a good excuse to be doing so, to try to scare healthy people away from waiting until they get sick to pay for coverage.

To buy individual major medical coverage outside of the annual open enrollment, consumers must show they qualify to apply for coverage through a “special enrollment period.”

Consumers can buy many other types of health insurance products that fall outside the scope of the ACA major medical insurance rules, such as short-term health insurance, at any time of the year.