“One would expect to see an uptick in the number of uninsured for two reasons: (1) the financial penalty for being uninsured will be removed beginning in 2019, and (2) premiums will rise due to adverse selection, by an estimated 10%, although most people are protected through rising financial subsidies. Estimates by the Congressional Budget Office project that by 2027, five million Americans would lose individual coverage; another five million, Medicaid coverage; and three million more, employer coverage [11]. Moreover, the Trump Administration has made various administrative decisions that will lead to fewer people choosing to purchase coverage, including: (1) occasionally stating that it would not have the Internal Revenue Service enforce the tax penalties for those who choose to remain uninsured – this is relevant to 2018, when the individual mandate is still in force; (2) severely cutting funding for outreach during the annual open enrollment period, as well as the length of the period; (3) providing negative public statements about the ACA; and (4) choosing not to fund the so-called ‘cost-sharing subsidies.’

“Where, then, do things now stand? The Medicaid expansion remains in place in 31 states; those eligible will continue to receive coverage, which typically has a broad benefit package and little or no premiums or patient cost-sharing. However, because many physicians do not accept Medicaid patients, due in large measure to low fees, access is often not the same as for those with private insurance and Medicare. Regarding the exchanges, in spite of the efforts of the Trump Administration, outlined above, enrollment during the 2018 open enrollment period was fairly stable. In 2018, an estimated 11.8 million million people enrolled through the federal and various state exchanges, just 4% lower than the previous year [12]. Enrollment results are not yet in for the several states that have their own exchanges.”

Source: Thomas Rice, Lynn Y. Unruh, Ewout van Ginneken, Pauline Rosenau, Andrew J. Barnes, Universal coverage reforms in the USA: From Obamacare through Trump, Health Policy, Volume 122, Issue 7, 2018, Pages 698-702, ISSN 0168-8510, https://doi.org/10.1016/j.healthpol.2018.05.007. http://www.sciencedirect.com/science/article/pii/S0168851018301544