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ACA enrollment 'surge' will likely be smaller than years past

Open enrollment is almost over. Photo: Alex Bradon / AP

Enrollment through HealthCare.gov closes on Friday, meaning it's time for "The Surge" — the rush of applications that usually coincides with big enrollment deadlines. Total sign-ups are lagging well behind previous years. If that gap is going to close even slightly, it'll be this week's surge that closes it.

The bottom line: Although there are theoretical reasons why this week could bring an especially big enrollment surge, the smart money is on a smaller-than-usual bump, leading to a significant decline in total enrollment.

How it works: It's incredibly hard to predict how big this year's wave of last-minute sign-ups will be, in large part because this year's enrollment period is structured so differently.

  • In years past, there were two key deadlines: A deadline for coverage that began Jan. 1, and then a final deadline that came later in January. This year, they've been rolled into one.
  • The widespread availability of plans that won't require consumers to make a monthly premium payment should, theoretically, be extra enticing to the young and healthy people who tend to make up a lot of the last-minute sign-ups.
  • But that only works if those consumers know those cheap plans are available, and President Trump's outreach cuts make that unlikely.

What they're saying: Although there are theoretical reasons why this week could bring an especially big enrollment surge, the smart money is on a smaller-than-usual bump, leading to a significant decline in total enrollment.

  • ​Avalere's Caroline Pearson said the range of possibilities for this week's sign-ups is probably somewhere between 2.3 million and 3.7 million.
  • ​"I'm doubtful that there's going to be massive wave of enrollment in the next week as the deadline approaches. With dramatically less outreach and near silence from senior administration officials from the president on down, it's entirely possible the deadline could pass without many potential enrollees even knowing about it," the Kaiser Family Foundation's Larry Levitt said.