At the Health Affairs Blog, I looked at the on-Exchange enrollment changes in 2018 stratified by the type of exchange and the state strategy for dealing with the termination of Cost Sharing Reduction (CSR) subsidies.
This is the money exhibit:
Unsurprisingly, to me at least, pricing matters. Silver Loading, the CSR strategy that placed all of the CSR costs into the Silver plans, saw the comparatively best results. I believe this is because Silver Loading strategies lowers the relative price of Bronze and Gold plans while holding Silver plan premiums constant for subsidized buyers. Lower prices for two plan categories and constant pricing for the third should lead to some increased demand.
Silver Loading was not a panacea for enrollment. Silver Loaded states saw a 3% enrollment decline as a whole but there were some states with significant enrollment gains. I thought that the split in experience between Healthcare.gov states and state branded website states to be interesting as well. I am using state branded websites as a mental proxy for local support for the ACA (Idaho is a notable exception). I think that local support and better pricing will produce better results than less local support and more federal counter-messaging to enrollment despite better pricing.
But the short story is the expected story: prices matter.