Sally Pipes: "Declining Obamacare Enrollment Isn’t the Crisis Critics Claim"

The following is an excerpt from an article by Sally Pipes, Founder & Chair of the Benjamin Rush Institute, published in the Washington Examiner. Click here to read the full article in your browser.

Enrollment in Obamacare’s exchange is falling, according to a new analysis from the Commonwealth Fund.

The study suggests that the expiration of the enhanced premium subsidies enacted during the pandemic has made coverage unaffordable for many Americans. Some consumers undoubtedly have decided that exchange plans are no longer worth the cost.

But that explanation overlooks a different possibility. A substantial share of Obamacare’s recent enrollment growth may never have reflected legitimate coverage in the first place.

According to a report from the Paragon Health Institute, roughly 12 million marketplace enrollees generated no insurance claims in 2024. It strains credulity to believe that all of those individuals simply remained healthy throughout the year. A more plausible explanation is that many were enrolled without their knowledge by brokers seeking commissions tied to sign-ups.

Federal regulators have acknowledged that this is a real problem. In 2024, the Centers for Medicare and Medicaid Services received hundreds of thousands of complaints involving unauthorized enrollments and plan switches. CMS subsequently suspended hundreds of brokers pending investigations into alleged misconduct.

The enrollment decline may also reflect a reduction in improper sign-ups. A separate Paragon analysis estimates that more than 6 million exchange enrollees this year may not actually qualify for the subsidies they receive or may otherwise be improperly enrolled.

Those findings are consistent with broader evidence that Obamacare’s enrollment figures are disconnected from reality.

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