By Sabrina Corlette and Rachel Schwab

On November 1, the Affordable Care Act’s (ACA) insurance marketplaces will launch their sixth enrollment season. This year, the challenges they face may be greater than laster year, with the loss of the individual mandate penalty as an enrollment incentive and the emergence of a parallel, unregulated market that could siphon away healthy enrollees. Yet the Trump administration has dramatically cut back federal investments in marketplace advertising and consumer assistance for the second year in a row. While these cuts likely mean a missed opportunity to reach and cover new people – and could dampen enrollment – in many federally run marketplaces, those operated by states are continuing to invest heavily in such activities, and are likely to reap the benefits.

In their latest post for The Commonwealth Fund’s To the Point blog, CHIR’s Sabrina Corlette and Rachel Schwab reveal the results of a survey of state-run marketplaces that asked about their budgets for their Navigator and advertising programs this year. In general, they find that the state-run marketplaces are spending roughly 26 times more per uninsured person than the federally run marketplace. These states are betting that these investments will result in more robust enrollment, a healthier risk pool, and greater competition among insurers. You can view state-by-state spending and a discussion of the data here.