More than 2.4 million people signed up for coverage through HealthCare.gov in the first four weeks of the Affordable Care Act's sixth open enrollment, about 350,000 fewer than during the same period last year.
While insurance exchange premiums for 2019 coverage are lower for many people across the nation, the absence of the individual mandate penalty next year and expanded availability of alternative coverage could be contributing to the slow-down in enrollment.
Other factors including less funding for ACA navigators and marketing and advertisements are also likely to dampen total enrollment. A Kaiser Family Foundation poll released Wednesday showed that about 69% of Americans who buy their own insurance did not know that open enrollment ends in most states on Dec. 15.
The CMS numbers don't include enrollment in states that operate their own exchanges. It also does not include people who will be automatically enrolled in plans during the last week of open enrollment.
The CMS also said Wednesday that of the nearly 11.8 million people who signed up or were automatically enrolled in 2018 coverage during the previous open enrollment, about 10.3 million people paid their premiums through June 30 and had an active policy.
That's slightly higher than the 10.1 million people who had paid their premiums during the first half of 2017, showing that more people today are staying enrolled in their plans.