A record 13.6 million Americans had already signed up for health coverage for 2022 on the Affordable Care Act marketplaces by mid-December, the Biden administration announced last month.
Open enrollment for the marketplace began Nov. 1 and ends Jan. 15.
The 13.6 million enrollment number includes people who used state-run marketplaces, in addition to those who enrolled through the federally run Healthcare.gov portal that handles sign-ups for more than 30 states.
The previous marketplace enrollment record was 12.7 million in 2016, the final year of President Barack Obama’s administration. Enrollment largely stagnated under President Donald Trump, who cut tens of millions of dollars in funding for navigators, who help people sign up for coverage.
President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans. The big driver behind the enrollment gains is new discounts on premiums.
As part of a COVID-19 relief bill passed this year, Congress increased the subsidies consumers receive when they enroll in health insurance via the marketplace. CMS said 92% of people in Healthcare.gov states will get the tax credits for 2022 coverage. Xavier Becerra, secretary of the U.S. Department of Health and Human Services, said that for four in five enrollees, monthly premiums cost $10 or less, which he said is “less than going to a movie.”
Moreover, more than 400,000 people will receive tax credits for 2022 coverage, to date, that would have been inaccessible to them prior to the ARP.
In addition, the federal government is using four times the number of navigators, or insurance counselors, to help people sign up for insurance. In non-expansion states, “our outreach efforts have been so robust this year,’’ said Chiquita Brooks-LaSure, administrator of the Centers for Medicare & Medicaid Services.
Enrollment has jumped more in states that have not expanded Medicaid because they have more uninsured residents than expansion states. In expansion states, people with incomes from 100% to 138% of the federal poverty level — about $12,880 and $17,770 for an individual — can enroll in Medicaid. In states that haven’t expanded the program, they can get subsidies to enroll in private plans through the Affordable Care Act marketplaces.
Another driver of enrollment is that some people may have lost job-based coverage during the pandemic and are seeking insurance on their own. The marketplaces also offer consumers more choices than in previous years. The average consumer now has between six and seven insurers to choose from, up from four to five in 2021, federal officials said.