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The Trump Effect: Postinauguration Changes in Marketplace Enrollment.

Publication ,  Journal Article
Anderson, D; Shafer, P
Published in: Journal of health politics, policy and law
October 2019

On January 20, 2017, President Donald Trump penned his first executive order, which aimed to "minimiz[e] the economic burden" of the Affordable Care Act, signaling his intent to make good on promises to repeal and replace the law. This executive order, along with concurrent changes in political messaging associated with the transition in power and reductions in HealthCare.gov advertising, lowered Health Insurance Marketplace enrollment at the end of the 2017 open enrollment period.The authors used difference-in-differences and event-study models with weekly county-level Marketplace application data from 1,476 counties in 37 states to estimate the incremental enrollment loss in the postinauguration period.Estimates indicate a population-weighted decline of over 700 applications per county-week during the final 2 weeks of the 2017 open enrollment period relative to 2016, corresponding to a nearly 30% decline in applications submitted. A more flexible event-study approach that better accounts for time shifting of enrollment across open enrollment periods found a similar decline of approximately 660 applications per county-week associated with the postinauguration period (-24%).The lack of political support for the law by the incoming administration seemingly had an immediate and significant downward effect on Marketplace enrollment nationwide.

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Published In

Journal of health politics, policy and law

DOI

EISSN

1527-1927

ISSN

0361-6878

Publication Date

October 2019

Volume

44

Issue

5

Start / End Page

715 / 736

Related Subject Headings

  • United States
  • Regression Analysis
  • Politics
  • Models, Statistical
  • Local Government
  • Insurance Coverage
  • Health Policy & Services
  • Health Insurance Exchanges
  • Data Collection
  • Advertising
 

Citation

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Anderson, D., & Shafer, P. (2019). The Trump Effect: Postinauguration Changes in Marketplace Enrollment. Journal of Health Politics, Policy and Law, 44(5), 715–736. https://doi.org/10.1215/03616878-7611623
Anderson, David, and Paul Shafer. “The Trump Effect: Postinauguration Changes in Marketplace Enrollment.Journal of Health Politics, Policy and Law 44, no. 5 (October 2019): 715–36. https://doi.org/10.1215/03616878-7611623.
Anderson D, Shafer P. The Trump Effect: Postinauguration Changes in Marketplace Enrollment. Journal of health politics, policy and law. 2019 Oct;44(5):715–36.
Anderson, David, and Paul Shafer. “The Trump Effect: Postinauguration Changes in Marketplace Enrollment.Journal of Health Politics, Policy and Law, vol. 44, no. 5, Oct. 2019, pp. 715–36. Epmc, doi:10.1215/03616878-7611623.
Anderson D, Shafer P. The Trump Effect: Postinauguration Changes in Marketplace Enrollment. Journal of health politics, policy and law. 2019 Oct;44(5):715–736.
Journal cover image

Published In

Journal of health politics, policy and law

DOI

EISSN

1527-1927

ISSN

0361-6878

Publication Date

October 2019

Volume

44

Issue

5

Start / End Page

715 / 736

Related Subject Headings

  • United States
  • Regression Analysis
  • Politics
  • Models, Statistical
  • Local Government
  • Insurance Coverage
  • Health Policy & Services
  • Health Insurance Exchanges
  • Data Collection
  • Advertising