La. sign-ups for Obamacare exchanges falls quickly

Despite lower premiums, the number of people enrolled in health insurance through the Affordable Care Act’s individual exchange in Louisiana fell sharply in 2019, reaching its lowest point since taking effect, as people migrated to other forms of insurance such as Medicaid through an expansion of that program through the ACA, as well as an improving economy that has given more people access to insurance through an employer.
But those using the individual exchanges and gaining coverage from the Medicaid expansion under the Affordable Care Act again found the insurance under attack Tuesday, with the Trump administration telling a New Orleans appeals court that the health law should be thrown out entirely. While the Trump administration has taken several steps to undermine the Affordable Care Act, the move was the most dramatic effort yet to end former President Barack Obama’s signature health care law.
The Affordable Care Act has had a significant effect on Louisiana’s health care landscape, mainly through the expansion of Medicaid as an option for states under the ACA that Gov. John Bel Edwards acted on.
Edwards said Tuesday eliminating the ACA “is not the answer.” More than 500,000 people are enrolled in the Medicaid expansion, which is threatened by the move to toss the ACA, Edwards noted. Nearly 850,000 people with pre-existing conditions in Louisiana “face uncertainty” amid talk of ending ACA, the Louisiana Department of Health said.
The expansion of Medicaid, a health insurance program for the poor, in turn, has affected enrollment in the individual exchange, which has served as a safety net, providing federal subsidies to about 90 percent of those enrolled in Louisiana to help pay for their health coverage.
Enrollment in the individual exchange in the state fell by 15 percent for 2019 to 92,948. That was the lowest number enrolled in the state since the exchanges took effect in 2014, figures from the U.S. Centers for Medicare and Medicaid services show.
The numbers represent the third straight year enrollment in the Affordable Care Act exchange here has fallen since peaking in 2016 at 214,000. Nationally, enrollment fell slightly to 11.4 million for 2019 plans.
Frank Opelka, deputy commissioner for life, health and annuity, said Medicaid expansion is a “well-known core driver of population loss from the ACA individual market.” For instance, in states like Louisiana and Virginia that expanded Medicaid more recently, Opelka said the ACA individual market populations fell more quickly than states with more stable Medicaid populations.
A growing economy also appears to be having an effect on the individual exchange, which offers insurance to people who don’t receive it through work, Medicaid, Medicare or other means. As more people find work, they are usually eligible for employer-sponsored health insurance.