Charles Gaba has some data from Health Sherpa regarding enrollment in the first week of the 2018 Open Enrollment Period.
HealthSherpa is seeing three times as many people buy Gold plans this year compared to last year. They are also seeing net of subsidy premiums go down by 12%. Some of this is a composition shift as more people are buying Bronze but so far the average blended actuarial value purchased on HealthSherpa is constant. Most of that is due to the CSR Silver Load.
I don’t believe that Cost Sharing Reduction subsidies will ever be appropriated. I believe that the facts on the ground are changing and the lived perception of the ACA is changing. Colin Baillio has a good example of that changed reality for Albuquerque, New Mexico.
— Colin B (@colinb1123) November 10, 2017
The politics of the ACA and healthcare are going to get weirder. Anyone who is not an actuary, a policy wonk or an insurance company plumber won’t care about the mechanics of why premiums are lower and some people have much lower deductibles. Most people will just care that their lived experienced is better. It won’t be everybody. Non-subsidized buyers still need help. States need to submit re-insurance or premium cap waivers for the non-subsidized population, but more people will have a better lived experience of the ACA in 2018 than in 2017.
I think a lot of vulnerable Republicans in 2018 will try to use the same message that vulnerable Democrats used in 2014 — “Don’t End, Mend….” and point to how the ACA has improved for some people in their districts through no responsibility of their own actions.