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The number of Lancaster County residents who got insurance through the Affordable Care Act marketplace dropped about 16 percent this year, new federal data show.

The report puts total 2018 enrollment here at 13,588, down from 16,082 in 2017 and 17,407 in 2016 and 17,754 in 2015.

That compares to a 9 percent enrollment drop in Pennsylvania, from 426,059 to 389,081, and a 3 percent enrollment drop nationwide, from 12.2 million to 11.8 million.

Cost changes

The report also shows that the average base monthly premiums rose significantly, to $890 per person in Lancaster County, $700 in Pennsylvania and $621 nationwide. Lancaster County numbers for 2017 weren’t reported, but the Pennsylvania average that year was $533, and the federal one was $476.

However, the report also showed a sharp rise in federal subsidies that resulted in most enrollees paying less per month. The subsidies, also called tax credits, are awarded on a sliding scale up to 400 percent of the federal poverty level, or about $48,000 for a single person, just under $65,000 for a couple and just over $98,000 for a family of four.

Nearly 11,700 Lancaster County residents got subsidies averaging $794 a month — up from $568 the previous year — which brought their monthly out-of-pocket premium cost average to $125.

Statewide, 329,132 enrollees got subsidies averaging $631, which brought their out-of-pocket premium costs to $94 a month. Nationwide, 83 percent of enrollees got subsidies that brought their average monthly premiums to $89.

Insurers and state insurance officials across the nation attributed much of the base price increase to a Trump administration decision to stop reimbursing insurers for cost-sharing reductions the law requires insurers to offer enrollees on the lower end of the income scale.

Overall, that decision ended up cutting costs for most lower-income enrollees even as it hiked them for higher-income folks and increased federal subsidy costs.