ACA exchange enrollment lags as deadline nears

With less than a week to go before open enrollment for 2020 health insurance exchange coverage ends in most states, signups trail last year's totals by about 6%, the federal government said Wednesday.

Roughly 3.9 million people enrolled in an Affordable Care Act exchange plan in the first six weeks of open enrollment, which ends on Dec. 15 for the states that use the federally operated HealthCare.gov. Plan selections have dropped about 250,000 over the same time in 2018.

Signups, while lower than last year's, are decreasing at a slower rate than in the year before, when sign-ups in the sixth week of open enrollment were down almost 12%. The latest figures don't include the millions of people who will be automatically enrolled in coverage at the conclusion of open enrollment. A last-minute surge in sign-ups is also typical as people rush to choose a health plan before the deadline.

Meanwhile, the CMS on Wednesday also reported that the majority of people who selected a plan during the previous open enrollment for HealthCare.gov and state-based exchanges have held onto their coverage through the first half of 2019.

Federal data showed that 10.2 million people paid their premiums to maintain 2019 coverage through June. That's a decrease from the same time last year of less than 1%. About 11.4 million people chose a plan on the federal and state exchanges during last year's open enrollment.

Earlier this week, the Kaiser Family Foundation published an analysis estimating that 4.7 million uninsured people are eligible to buy a bronze-level ACA exchange plan for $0 in premiums after federal subsidies, though the plans do have high deductibles. More than half of these uninsured individuals live in Georgia, Florida, North Carolina and Texas.