Take Care: The Affordable Care Act In 2018

The deadline to enroll in health care coverage under the Affordable Care Act (ACA) for 2019 is December 15. But enrollment for the program is down in many parts of the country.

Last week, Politico reported “that just 3.2 million people enrolled through HealthCare.gov versus 3.6 million at this point last year.”

However, interest in the ACA remains high — health care was the most Googled issue ahead of the midterm election.

And Fortune reports that the ACA remains popular in many states.

Voters in Idaho, Nebraska, and Utah overwhelmingly endorsed ballot initiatives to approve Medicaid expansion. What's more, Kansas, Maine, and Wisconsin all elected Democratic governors who are gung-ho expansion proponents, possibly setting up a significant rise in coverage for poor, working residents. (Of note—Utah also elected former Massachusetts governor and 2012 GOP presidential candidate Mitt Romney, who enacted the earliest form of Obamacare in MA, as its next U.S. Senator.)

However, Democrats' inability to capture a hotly-contested gubernatorial race in Florida means that state will almost certainly continue to remain outside the Medicaid expansion column. Florida and Texas are the two biggest remaining states not to take part in the program.

One thing to keep an eye on: An ongoing multi-state lawsuit supported by the Trump administration that would nix Obamacare's protections for people with pre-existing medical conditions and could wind up at the Supreme Court.

So why is enrollment down? The The New York Times. suggests it could be because the ACA's individual mandate—the provision that required people to have insurance—is no longer law.

Here's what the repeal of the individual mandate means, per Vox:

Repealing the mandate — which is the gear that makes the Affordable Care Act tick — is estimated to save more than $300 billion over 10 years, but only because millions fewer Americans would have health insurance, according to the Congressional Budget Office. It also means higher premiums, because the younger and healthier people who have an incentive to buy insurance rather than pay the mandate would be expected to exit the market while the sicker people stay in.

Here’s Obama’s pitch for this year.

No jump shots. No ferns. No memes. Not this time. I'm going to give it to you straight: If you need health insurance for 2019, the deadline to get covered is December 15. Go to https://t.co/ob1Ynoesod today and pass this on — you just might save a life. pic.twitter.com/8mHMsXGY0g

— Barack Obama (@BarackObama) December 10, 2018

What does this mean for the health of the country?

If you are trying to enroll, you can visit healthcare.gov or call 1-800-318-2596.

GUESTS

Dan Diamond, Health Reporter, POLITICO; Host, “Pulse Check” Podcast; @ddiamond

Cynthia Cox, Director, Program for the Study of Health Reform and Private Insurance, Kaiser Family Foundation; @cynthiaccox

Erin Hemlin, Director of Training and Consumer Education, Young Invincibles,

@erinhemlin

For more, visit https://the1a.org.

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