Health coverage signups lag as deadline looms

WASHINGTON — With just days left to enroll, fewer people are signing up for the Affordable Care Act, even though premiums are stable, more plans are available and millions of uninsured people can still get financial help.

Barring an enrollment surge, the nation’s uninsured rate could edge up again after a years-long coverage expansion that has seen about 20 million people obtain health insurance.

A status report Wednesday from the Centers for Medicare and Medicaid Services showed nearly 20 percent fewer new people signed up than at about the same time last year. New sign ups drive the growth of the HealthCare.gov marketplaces, helping keep premiums in check.

The sign up deadline in most states is this Saturday, for coverage beginning Jan. 1.

Disappointing sign ups will add to the long-running political blame game over health care. Democrats accuse the Trump administration of “sabotage” on the health law. Republicans counter that pricey Obama-law premiums are too high for solid middle-class people who don’t qualify for taxpayer-financed subsidies.

Interviews with current and former officials, consumer organizations and independent experts revealed several factors that appear to be cutting into enrollment.

The Trump administration didn’t set sign up targets for the health overhaul, according to a report this summer from the nonpartisan Government Accountability Office.

The GOP-led Congress repealed the fine for being uninsured, effective this Jan. 1. The tax penalty was the most unpopular part of Obama’s law.

Organizations working to enroll low-income workers report heightened concerns among immigrants that applying for health insurance could have negative consequences due to the administration’s crackdown on illegal immigration. Only legal immigrants and citizens can get coverage through HealthCare.gov, but that hasn’t calmed the fears.

Last year about 11.8 million people signed up for subsidized private health insurance during the ACA’s open enrollment period. Some 10 million are still enrolled.

Separately, another 12 million low-income people are covered through the health law’s Medicaid expansion.