The decline was concentrated in states where the federal government runs the Obamacare markets. In those 34 states, enrollment dropped 5.3 percent.

In states that handle their own systems and advertising, like New York, Colorado and California, sign-ups were essentially flat. States that run their own markets also typically offered longer sign-up periods.

Despite the smaller-than-expected decline, enrollment in the ACA’s exchanges has fallen from a peak of about 12.7 million in 2016, and the overall individual market has turned out to be smaller than estimated when the health law was passed.

One reason the numbers haven’t gone up may be that people are still getting coverage through their jobs in high numbers. When the health law was passed, policy experts predicted that some companies would quit offering coverage, sending workers to the Obamacare market.

Instead, companies continued offering insurance to their workers as a job benefit. A strengthening labor market may also have helped pull some people out of the ACA’s exchanges. More than 2 million more people were employed in January compared to a year earlier.

While premiums climbed, the overall effect on enrollment is unclear. On average, the sticker price of the cheapest plans rose 17 percent, according to the Kaiser Family Foundation. That likely drove some people too wealthy to get subsidies away from the market. But because subsidies rise alongside premiums, lower income consumers were insulated from the price hikes.

Instant Insights /

Obamacare signups down just 3.7 percent in 2018

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