About 11.8 million Americans got a 2018 health care plan through the federal and state marketplaces, according to numbers released by the Centers for Medicare and Medicaid Services on Tuesday.
The final tally is down from the 12.2 million people who got health insurance for 2017 through the exchanges. It's also a small miracle, given the current administration and governing party are openly opposed to former President Barack Obama's health care law.
The cost of Obamacare in 2018
For many 2018 enrollees, plans were actually cheaper. Premiums spiked year-over-year, to $621 a month from $476 a month in 2017, but so did the average premium tax credit.
Nearly 9.8 million people eligible for a subsidy (83% of enrollees) are paying an average of $89 per month for their 2018 health plan, a downtick from the $106 per month average last year.
How did that happen? Thank President Donald Trump. His last-minute decision to cut cost-sharing reduction (CSR) payments to insurers led directly to an increase in the price of silver plans, which determines the amount of the premium tax credit.
What does that mean for Obamacare 2019?
Not much. The health insurance marketplaces might have weathered — at least collectively — the CSR cuts ... and the slash to the federal advertising budget ... and a significantly shorter Healthcare.gov open enrollment period. But new challenges are ahead.
Most notably, Republicans in December overturned the tax penalty for foregoing health insurance, effective in 2019. And the Trump administration's push to expand sparse short-term health insurance plans is likely to pull healthier people away from the marketplace. Both moves are expected to lead to higher premiums, particularly for people who don't qualify for subsidies, and lower enrollment rates.
We've got more on what the exchanges could look like during the next open enrollment period here.