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Obamacare enrollment period ending amid uncertainty about President Trump’s impact on it

Jan. 31, 2017 Updated Tue., Jan. 31, 2017 at 10:42 a.m.

Dozens of Affordable Care Act supporters gather for a rally held Saturday, Jan. 28, 2017, in downtown St. Joseph, Mich. (Don Campbell / Associated Press)
Dozens of Affordable Care Act supporters gather for a rally held Saturday, Jan. 28, 2017, in downtown St. Joseph, Mich. (Don Campbell / Associated Press)
By Amy Goldstein Washington Post

WASHINGTON – The Affordable Care Act’s fourth open-enrollment season draws to its scheduled close at midnight Tuesday amid uncertainty over how much actions by the Trump administration to undercut the law might affect the number of Americans signing up for health insurance through its marketplaces.

As of Monday, grassroots Get Covered groups in three dozen states had 30 percent fewer consumers requesting online appointments to get assistance in choosing health plans compared with a year ago, according to the nonprofit organization Enroll America.

It was unclear whether those 76,000 appointments mean that fewer people are actually signing up. There could be more walk-in customers, more returning buyers who don’t need any help or another possible explanation, such as this year’s different advertising strategies.

Despite a presidential executive order to relax federal rules under the ACA and seesawing decisions to stop and then partly restart consumer outreach, the new White House has not touched mainstays of the enrollment operation.

The website for the federal insurance exchange on which 39 states rely continues to operate. “Last chance to enroll – January 31,” the site’s familiar blue-and-white home page still said Monday night, and consumers could still get questions answered at federal call centers around the country.

Yet the 2017 open-enrollment period could be the last under the ACA, depending on what happens in Congress in coming months. President Donald Trump and Republican lawmakers have said that dismantling the 2010 law is a top priority. Although there is no consensus about what will succeed it, they have said they want a smooth transition for the roughly 10 million Americans with individual health plans through the federal exchange and similar state-run marketplaces.

For now, the looming question is the short-term impact of the Trump administration’s anti-ACA rhetoric and the actions officials already have taken. “The ultimate arbiter will be the 1/8enrollment 3/8 numbers,” said Jennifer Sullivan, Enroll America’s vice president for programs.

Sullivan said that, in the days since Trump took office, people assisting with enrollment around the country have gotten an influx of questions from consumers uncertain whether the law’s features remain intact. Some are asking whether the ACA still requires most Americans to have health insurance or risk a federal fine.

The executive order the president signed on his first night in office does not specify which regulations would be eliminated, but it calls for agencies to reverse rules that place a financial burden on individuals, suggesting that enforcement of the law’s coverage mandate might be lifted. No ACA rules have been rewritten so far.

Last week, when the White House directed the Health and Human Services Department to stop all enrollment outreach activities, ACA proponents and insurers warned that the action was likely to suppress sign-ups by the most desirable customers – younger and healthier people who tend to act right before the deadline. Stung by the outcry, the administration partly reversed course, reinstating Twitter notifications as well as emails and robo-calls to potential ACA customers. It also permitted television, radio and digital ads that HHS already had paid to air if the government could not get a refund.

As open-enrollment ends, one other unknown is how much the new administration will say about the final numbers. Sign-ups were running slightly ahead of a year ago as of earlier this month. Outgoing Obama administration officials in HHS took the unusual step of announcing when future enrollment updates would be provided.

Their schedule called for a “snapshot” this Friday that would contain the full sign-up tally from the federal insurance exchange. A spokesman for the Centers for Medicare and Medicaid Services, the HHS agency overseeing much of the ACA’s implementation, said Monday that those figures were still expected.

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