Commentary, Trump Administration

New analysis documents devastating impact Trump’s ACA sabotage has had on health care coverage

Researchers at the Center for American Progress released a new analysis this morning which shows that at this critical moment for access to health care, well over a million additional Americans would be enrolled in marketplace coverage if not for President Trump’s continuing efforts to sabotage the Affordable Care Act.

This is from the news release that accompanied the new analysis:

Washington, D.C. — Today, the Center for American Progress released new column examining trends in Affordable Care Act (ACA) marketplace enrollment and the effect President Donald Trump’s sabotage has had on stunting the public’s ability to obtain coverage. The analysis looks at disparities in enrollment patterns in both the federally facilitated marketplaces (FFM) operated by the Centers for Medicare & Medicaid Services (CMS) and state-based marketplaces (SBM) operated by the states.

The authors estimate that at least 1.26 million more people would be enrolled in marketplace coverage today if not for the Trump administration’s attacks on the ACA, and total enrollment would have at least held steady near its 2016 level instead of falling.

“We’re in the middle of a public health crisis that has crippled our economy, causing millions to lose their jobs and employer-provided insurance. This analysis shows that the administration’s refusal to create a coronavirus special enrollment period is just their latest effort to make it harder for people to get and stay covered,” said Emily Gee, health economist at CAP and co-author of the column.

And this is from the introduction to the analysis:

Since the first day of his administration, President Donald Trump has repeatedly tried to repeal the Affordable Care Act (ACA), even though it provides crucial consumer protections for health coverage and has led to nearly 20 million more Americans gaining insurance since it was signed into law in 2010. While the ACA remains in place, three years of Trump’s policies have taken a toll on enrollment in the ACA’s health insurance marketplaces. According to new data published by the federal Centers for Medicare & Medicaid Services (CMS), 11.4 million people signed up for 2020 coverage—a decline of 1.27 million people (10 percent) since 2016.

While the ACA’s reforms created marketplaces for people buying insurance directly from insurers in every state, individual states can choose to operate their own marketplace enrollment platforms, allowing them a greater degree of control over outreach efforts and enrollment rules. Comparing enrollment trends among such state-based marketplaces (SBMs) against those in states that instead use the federal government’s enrollment platform—known as the federally facilitated marketplace (FFM)—provides a picture of how enrollment may have fared in the absence of the Trump administration’s sabotage from 2017 to 2020. The Center for American Progress estimates that at least 1.26 million more people would be enrolled in marketplace coverage today if not for the Trump administration’s attacks on the ACA, and total enrollment would have at least held steady near its 2016 level instead of falling.

The novel coronavirus pandemic highlights the importance of comprehensive insurance coverage. To date, a dozen states have reopened enrollment to the uninsured because of the COVID-19 pandemic, recognizing both the importance of comprehensive insurance coverage for COVID-19 testing and treatment as well as for helping to mitigate the financial strain caused by the pandemic, seen most clearly in millions of people becoming unemployed. Despite calls from more than 200 organizations to create a nationwide enrollment opportunity in this time of crisis, the Trump administration has so far refused to reopen marketplace enrollment.

Click here to read “How Trump’s Policies Have Hurt ACA Marketplace Enrollment.”

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