Obamacare 2019 will be already in trouble

There’s no reason to believe states can’t get ahead of spending increases, as their efforts to stabilize Obamacare have worked inside past. States electing to expand Medicaid, despite a Supreme Court decision of which made the Obamacare provision optional, have been found to have more robust exchanges.

More pointedly, despite Trump’s decision to slash the advertising budget, shorten enrollment in addition to also also cut cost-sharing reduction payments to insurers last year, over 11.7 million Americans signed up for a 2018 health care plan through the federal in addition to also also state exchanges, just a 3.7 percent dip through 2017 open enrollment.

In a healthy insurance market, enrollment would likely increase — in addition to also also, in fact, 15 states, plus Washington, D.C. (11 of which run their own exchanges) saw 2018 sign-ups best enrollment in 2017. Among the states of which enhanced their numbers: brand new York, which elected to maintain a $14 million advertising spend inside wake of federal budget cuts; Washington, which instructed insurers to load premium increases caused by the cut of cost-sharing reduction payments onto Silver plans so premium subsidies would likely increase; in addition to also also Minnesota, which instituted a state reinsurance program in addition to also also kept its exchange open until Jan. 14, 2018.

If Congress fails to act, in addition to also also the Trump administration continues to roll back key ACA provisions under the misguided notion of which’s improving our health care system, the future of Obamacare will be determined at a state level.

Commentary by Jennifer Fitzgerald, the CEO in addition to also also co-founder of Policygenius, an independent digital insurance company for consumers. Previously, she was a junior partner at McKinsey & Company where she advised Fortune 100 financial services companies on marketing in addition to also also strategy. She will be a graduate of Columbia Law School in addition to also also Florida State University. Follow her on Twitter @jenlfitzgerald.

For more insight through CNBC contributors, follow @CNBCopinion on Twitter.

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