Open enrollment for 2018 started last week on the Affordable Care Act’s health insurance marketplaces. Along with its executive actions designed to weaken marketplaces operations, the Trump administration has taken a number of steps over the past year to curb marketplace enrollment, such as making dramatic cuts in funding for enrollment navigators and advertising, scheduling shutdowns of HealthCare.gov during the 2018 enrollment period, and ending the long-standing partnerships between Health and Human Services officials and local enrollment assisters. But while the administration has scaled back efforts to provide health coverage, state-based marketplaces have taken a different approach. We interviewed executives at 15 of the 17 states that operate their own marketplaces. All have bolstered efforts to stabilize their markets and maintain or grow enrollment this year, despite the chaotic federal environment.
While the administration cut the open-enrollment period for the federally facilitated marketplace in half to 45 days, nine of the 12 state-based marketplaces with control over their open-enrollment periods extended them beyond the federal deadline. While the administration seized on headlines of insurer exits, state-based marketplaces worked diligently to maintain insurer participation. And while the administration reduced funding for outreach, state-based marketplaces either increased their marketing budgets or modified their strategies to counter misinformation and raise awareness of new deadlines.
To learn more about how state-based marketplaces are approaching open enrollment, visit the Commonwealth Fund blog here.