ACA signups reach record-breaking 14.5M thanks to enhanced subsidies, greater outreach

Signups on the Affordable Care Act’s insurance exchanges reached a record-breaking 14.5 million people thanks in part to enhanced subsidies set to expire after this year.

The Department of Health and Human Services gave an update on the signups through the end of open enrollment, which closed on Jan. 15, and combines numbers from and state-run exchanges. Administration officials pegged the increase to enhanced subsidies passed as part of the American Rescue Plan Act and increased outreach.

“It is not accidental or coincidental that so many Americans have quality health insurance and peace of mind,” said HHS Secretary Xavier Becerra during a call with reporters. “It happened because President Biden and this administration took action.”

Becerra highlighted an increased emphasis on outreach, including quadrupling the funding for ACA navigators who assist consumers and more targeted media outreach campaigns in underserved areas.

The 14.5 million in signups is a 21% increase over the signups for last year’s open enrollment period. Of the 14.5 million, there were 5.8 million that were new customers for ACA coverage.

Becerra noted that the open enrollment is still ongoing for the District of Columbia and five states: Kentucky, New Jersey, New York, Rhode Island and California.

In addition to a massive boost in funding for navigators, the administration focused on local media buys, said Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services on the reporter call.

“People got to hear from people who look and had lives like them,” she said.

HHS also released a report analyzing new survey data from the Assistant Secretary for Planning and Evaluation that showed the uninsured rate was 8.9% in the third quarter of 2021, down from 10.3% in the last quarter of 2020.

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But it remains unclear how long these gains in ACA coverage will last without the enhanced subsidies from the American Rescue Plan. The subsidies, which expire after this year, helped ensure a 23% decline in premiums for this year and some low-income consumers got no-cost plans.

The Build Back Better Act, which passed the House last year, would have extended the subsidies through 2025, but the legislation has stalled in the Senate. Now senators are hoping to break up the social spending package and it remains unclear if the enhanced subsidy extension would survive.

Sen. Chris Van Hollen, D-Md., said during the call that discussions are still ongoing in the Senate.

“I am confident we will get a number of the major provisions from the bill that passed the House through the Senate,” he said. “That increased premium help has dramatically boosted enrollment in different plans and made it much more affordable.”