Why it matters: The Affordable Care Act is expanding its reach.
Despite a recent warning from former President Donald J. Trump, the front-runner in the race for the 2024 Republican presidential nomination, that he was “seriously examining alternatives” to the Affordable Care Act, the latest surge in market enrollment is a testimony to the enduring power of the law.
Legislation passed earlier during the Covid-19 pandemic increased federal subsidies for people purchasing plans, reducing costs for many Americans. The Biden administration has also lengthened the enrollment period and increased advertising for the program and funding for so-called navigators who help people sign up.
“More and more people are realizing they can enter the market,” said Cynthia Cox, director of the Program on the Affordable Care Act at KFF, a nonprofit health policy research group.
He added: “Just because the ACA has been around for a while doesn’t mean the people who need to enroll know how to do it.”
An astonishing statistic: 750,000 registrations in a single day.
On Dec. 15 — the deadline to sign up for coverage that begins Jan. 1 — nearly 750,000 people opted for a marketplace plan on HealthCare.gov. It was the largest total ever achieved in a single day.
Dr. Benjamin Sommers, a Harvard health economist who served in the Biden administration, said better outreach helped explain the record enrollment. “I’m pleasantly surprised,” he said.
With years of increased subsidies, he added, “it may be that this is the natural growth rate over a few years in a new policy environment.”
Kody Kinsley, North Carolina’s top health official, said his state has gotten creative by using its efforts to expand Medicaid to also enroll people in marketplace plans.
“We had a very large education and outreach campaign — with civic organizations, churches, navigators — built around the expansion to educate people about eligibility,” he said in a text message.
He added, “As part of that, we help people get coverage on the marketplace if they’re not eligible” for Medicaid.
What awaits us: Registrations will continue for almost a month.
The open enrollment period on Healthcare.gov lasts through mid-January and ends at 5 a.m. Eastern time on January 17. People who sign up by that date will have coverage starting in February.
Biden administration officials said they were encouraging enrollees who were already covered by HealthCare.gov to continue purchasing plans, in case a new option proves better and more affordable.
The Affordable Care Act marketplaces have become especially valuable to people who lost Medicaid coverage this year after a federal policy that guaranteed coverage at the start of the pandemic expired in April.
The millions of people dropping off Medicaid rolls have contributed to increased marketplace enrollment, Cox said, and increases during normally sleepier periods outside of open enrollment. (Certain life events, such as the sudden loss of other health coverage, allow some Americans to get new plans outside of the open enrollment period.)
According to federal health officials, enrollment in marketplace plans increased by 1.6 million people from March to September, which is 1.5 million more than the same period last year.