Charles Gaba outlines what happened on Healthcare.gov for final enrollment. The numbers came in lighter than expected.
Then, Donald Trump actually took office…and in a one-two punch, not only signed an executive order which specifically instructed the HHS Dept. to do everything in their power to sabotage the implementation of the ACA, but also attempted to pull the plug on the critical last-minute advertising blitz which is so vital to reminding procrastinators (particularly young ones…you know, the ones who help the risk pool?) to get off their duffs and actually sign up.
On January 31, 2017, Open Enrollment for 2017 coverage ended with more than 9.2 million plan selections in states that use the HealthCare.gov eligibility and enrollment platform.
I was curious about something over the weekend but I was with my kids. I had to chase them and learn about rocket ships.
At the state level, does partisanship have a relationship to enrollment levels. Would states with a higher Trump vote percentage have greater declines in enrollment?
My data is here for any and all to view:
https://drive.google.com/open?id=0B0shrhgU2x-pZ0VXRE9YczZKd1E
I excluded Kentucky from the analysis as they transitioned from Kynect to Healthcare.gov. I also suppressed Louisiana as they had a mid-year Medicaid expansion so we should expect a massive drop in Louisiana enrollment no matter what (and that is what happened).
UPDATE 1: Removing Hawaii as an outlier transforms the relationship from statistically significant to not significant
The short answer is yes, and significantly so.It is not a perfect relationship as South Dakota and Utah each saw significant gains. But each point of Trump voters led to 4.5 basis points less enrollment. A state that perfectly mirrored Trump’s actual popular vote total would have had effectively not lost enrollment. A 50/50 state would have lost 2.5% of the QHP’s.
What is the mechanism? I don’t know. I would bet that elite cuing and partisan information channels would be a major part of this explanation. Trusted sources in red states were telling people that the markets were blowing up and outreach efforts were either hobbled or sidelined so the marginal people who were making the last buy/no buy decisions were making incremental no buy decisions. I think if we see an older than expected risk pool, that will be a chunk of evidence in support of that idea.
Partisanship and enrollment changes on Healthcare.govPost + Comments (13)