How New York and California hope to save Obamacare

Today is the first day of Obamacare’s annual open-enrollment period allowing people to sign up for insurance plans for 2018. Under the Trump administration, the federal exchange will be cutting the duration of open-enrollment from 12 weeks down to six. That, combined with increased prices and a cut in federal advertising, is expected to reduce the number of enrollees on the federal exchange next year. But Politico reports New York and California, which both run their own exchanges, are hoping to buck the national trend.

The task for the blue states — California, New York and others running their own exchanges — is to mute, or at least counter, President Donald Trump’s messaging in this fifth enrollment period. The president keeps declaring Obamacare “dead,” which confuses the public. His administration has also truncated the federal sign-up season to six weeks from 12, and slashed outreach and consumer assistance. It’s all part of his efforts to discourage enrollment and discredit the Affordable Care Act.

That becomes a self-fulfilling prophecy. The worse Obamacare performs this year, the easier it is for Republicans to keep depicting it as a failed program that must be scrapped…

While the federal government has cut Obamacare advertising and outreach from $100 million to $10 million this year, California increased spending this year to about $111 million — or more than 10 times what the federal government is paying for in the 42 states that rely on the federal HealthCare.gov site. New York has committed to spending $27 million on advertising and outreach, the same as last year…

Both states also committed early on to keeping the original 12-week enrollment period. They will both run until Jan 31, while the federal exchange sign-up will go from Nov. 1 to Dec. 15. Looking ahead, California even passed a new law establishing that its enrollment period will run from Oct. 15 through Jan. 15 starting in 2019.

Neither state is projecting a surge in enrollment, even with the extra weeks and added advertising money. New York refuses to offer any prediction of where things will stand next year. California, when pressed, will only say that it hopes to keep enrollment steady. “We anticipate having the same number of insured as we come out of open enrollment [next year] as we did in 2017,” Covered California’s Peter Lee tells Politico.

It’s worth remembering that in 2017, with a full 12 weeks of enrollment and a bigger advertising budget (a small fraction of which was cut in the final week by the Trump administration), Obamacare enrollment was down slightly from the previous year. The individual mandate was not working as anticipated and insurers were dropping out before Trump arrived. The effort by California and New York is a delaying action at best. At some point, a political solution to these problems was always going to be necessary, but at the moment any kind of compromise seems a long way off.