Declining Marketplace Numbers

Declining Marketplace Numbers

At first glance the chart below seems pretty straightforward.  The Affordable Care Act enrollment numbers began increasing in 2014 due to numerous factors and changes to the law, including, but not limited to, health insurance exchanges opening, federal subsidies were offered, small business tax credits were awarded, and restrictions on pre-existing conditions were lifted. Numbers increased greatly in 2015, slightly in 2016 and 2017, then began to decline in 2018, with a steep decline in 2019.

Yes, that is clear! ACA came into law, numbers increased.  President Trump was elected and promised to dismantle ACA in 2018, therefore the numbers decreased. The Individual Mandate was discontinued in 2019 and marketplace enrollment fell drastically, even below 2014 numbers.

Numbers obtained from:




Done. End of story!


Not so fast!

How about we take another look at some of the states that have yet to report for 2019? So far, according to the Kaiser Family Foundation “Marketplace Enrollment, 2014-2019” report, many states, including New York, Washington, and California have yet to report their enrollment numbers for 2019.  California alone held 13% of the reporting numbers in 2018. Other majorities are Massachusetts, New York, Washington, for a combined 6.6% of reporting numbers.  In total, over 20% of numbers have not been reported for 2019.

These states are unreported due to extended open enrollment periods. The list can be found HERE.

Putting those numbers in perspective:

Marketplace enrollment numbers have decreased nearly 4% on average since 2016.  If we apply that to 2019, but also take the 20% of non-reporting numbers into consideration, there is a higher rate of decrease, but not as substantial as we were first led to believe. According to the current numbers for 2019, the decrease appears to be nearly 40%. However, applying the non-reported numbers reduces the overall estimated decrease to 10%.


Yes, marketplace enrollment numbers are on the decline; what was around a 4% fall, jumped to a 10% reduction in 2019. Even though it is not the 40% we first believed, it is an escalation.  More than likely, the individual mandate caused the lessening enrollment for 2019; now we wonder what were the causes for the declining numbers in 2017 and 2018.