ACA sign-ups blow past 14M as Saturday deadline for open enrollment looms

More than 14.2 million people have bought a plan on the Affordable Care Act’s insurance exchanges as of Jan. 8, as the Biden administration makes a last-second sprint to boost awareness of the Jan. 15 deadline.

Of the record-breaking more than 14.2 million, there were 10 million people who signed up for coverage on the federally run and the remaining via state-based exchanges, administration officials shared during a call with reporters on Thursday. The administration has made a major boost to outreach this year to make consumers aware of enhanced subsidies and lower cost-sharing passed under the American Rescue Plan Act.

“Dependable healthcare coverage is in reach at affordable rates,” said Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure on the call.

A new federal report showed that the enhancements passed under the American Rescue Plan Act have impacted cost-sharing such as deductibles as well as premiums.

Deductibles for new consumers enrolling during the 2021 special enrollment period, which ended last August, fell from $450 to $50 after the American Rescue Plan’s premium enhancements went into effect on April 1, 2021, according to a report from the Assistant Secretary for Planning and Evaluation.

“Thanks to American Rescue Plan people don’t have to worry about meeting hefty costs and meeting the deductible,” Brooks-LaSure said Thursday.

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She added that while deductibles have increased for private insurance plans over the past decade, the deductibles for ACA coverage have been decreasing year-to-year over the past five years.  

However, the boosted subsidies are going to expire after the 2022 coverage year unless Congress acts. The Build Back Better Act proposed extending them again for several years but remains stalled in Congress.

CMS and HHS made a major push to increase funding for outreach and marketing for the ACA’s open enrollment, including a massive boost to navigators that assist consumers with enrollment options.

“We still have a couple more days. We want to continue to get the word out in all of the states,” Brooks-LaSure said.

The administration last year also reopened open enrollment last year through August in a bid for consumers affected by COVID-19 to sign up for coverage. HHS saw 4 million people sign up during the special period.

Becerra initially shied away from committing to another COVID-19 special enrollment period as the Omicron variant has caused an enormous surge in the virus. He told reporters that the open enrollment period was already extended for a month through Jan. 15.

The ACA already has special enrollment periods in place for major life events including job losses.

But Becerra didn’t rule out another such period.

“The president is all about helping more people get quality insurance coverage, that is why he campaigned about,” Becerra said. “I wouldn’t be surprised if he instructs us to look for ways for Americans to look for the coverage they need.”

Brooks-LaSure also expected a last-minute surge in sign-ups on the exchanges before Saturday’s deadline.

“We know how much people love a deadline,” she said.