The Death of the Affordable Care Act? Maybe not.

After his obituary was mistakenly published in a New York newspaper, Mark Twain sent a cable from London stating, “The reports of my death are greatly exaggerated.”

Similarly, last year’s headlines reporting the demise of the Affordable Care Act (ACA) were greatly exaggerated. Some of these headlines read:

“Obamacare is in a 'death spiral,' says Aetna CEO” - CNN Money, February 15, 2017

“The Obamacare death-spiral blues continues” - New York Post, February 15, 2017

“The Obamacare death spiral is quietly getting much worse” - Washington Examiner, August 29, 2017

The federal health insurance market for small group and individual plans may be in better shape than people think. According to the Kaiser Family Foundation, there are more than a dozen new entrants into the ACA marketplaces. Cynthia Cox, Kaiser’s director of health reform and private insurance, recently tweeted that 13 states can expect to have new insurers in 2019. Among those insurance companies are Oscar, Wellmark, Anthem, Molina, Centene, and Presbyterian. And -- unlike previous years -- Cox reported “zero exits” from existing markets thus far in 2018.

If we were to do a pulse check on ACA markets, which are still not fully mature, we would see that the markets today are doing pretty well and exploration among the sellers and buyers continues. Insurers are testing new markets and consumers are learning what they have to offer.

To many economists the survival of the federal exchanges is not a surprise. Markets, especially new ones, involve continuous exploration. They are constantly evolving. Prices and offerings shift as sellers explore what they can afford to offer, and buyers explore what is available at various prices.

Writing in the Washington Post in November of 2014, Alice Rivlin, former Director of the Congressional Budget Office and Office of Management and Budget, made a statement that still holds true today. "Should believers in market forces try to gut the Affordable Care Act?  Heavens, no," she said. "They should seize this huge opportunity to prove their case by helping to make the law’s markets work effectively."

Even after the Trump Administration’s recent announcement that it would halt about $10 billion in cost-sharing reduction payments and risk adjustment payments, health insurance companies appear to be forging ahead despite the uncertainty and politics that surround the law. Fitch Ratings said the largest U.S. health insurers aren’t likely to be at risk of negative credit ratings due to the move. “The major publicly traded health insurers and Blue Cross/Blue Shield plans do not appear to face a concerning level of deterioration in capital strength under any plausible scenario,” a report from Fitch stated.

Yes, the federal health care marketplace has endured hardships. It isn’t as competitive as many of its advocates had hoped, and shoppers in some parts of the country have only one insurer to choose from. But those woes are not necessarily predictive of the end of the ACA.

Last year's enrollment numbers for the federal marketplace were surprisingly strong, with 8.8 million customers selecting a plan by the sign-up deadline, according to the Centers for Medicare & Medicaid Services. That number was just about 400,000 fewer than the number that signed up during the prior enrollment season, despite warnings that millions fewer would enroll.

So the next time you hear predictions of the ACA’s death, it’ll probably still be too early to start digging the grave.