A record 15.9M people enrolled in ACA marketplace plans so far, CMS says

A record 15.9 million people have enrolled for insurance coverage on the Affordable Care Act marketplace through Jan. 7, representing a 13% increase over last year and setting a new record, according to the Centers for Medicare and Medicaid Services.

That’s 15.9 million and counting as people have until Jan. 15 to enroll on the HealthCare.gov website, although in some states the deadline extends beyond Sunday.

Department of Health and Human Services Secretary Xavier Becerra said in the CMS press release that “there are only five days left in open enrollment: do not miss your chance to enroll in high-quality, affordable health care.”

Becerra said incentives contained in the Inflation Reduction Act allow many individuals and families to obtain ACA coverage for $10 or less a month. In addition, enrollees will have a lot more to choose from this year, with 92% having access to three or more insurance companies when they shop for coverage.

“Standardized plans offer the same deductibles and cost-sharing for certain benefits, and the same out-of-pocket limits as other standardized plans within the same health plan category,” CMS said. “Most of these standardized plan options offer many services pre-deductible, including primary care, generic drugs, preferred brand drugs, urgent care, specialist visits, mental health and substance use outpatient office visits, as well as speech, occupational, and physical therapy.”

ACA enrollment as of Jan11

CMS said that “total plan selections include 3.1 million people (20% of total) who are new to the marketplaces for 2023, and 12.8 million people (80% of total) who had active 2022 coverage and made a plan selection for 2023 coverage or were automatically re-enrolled. About 1.8 million more people have signed up for health insurance, or a 13% increase, from this time last year.”

Some health insurance plans expanded their presence in the ACA marketplace this year, with UnitedHealthcare offering plans in 22 states, an increase from 18 states in 2022, and 11 states in 2021. Cigna said it will be offering ACA plans in Texas, Indiana and South Carolina this year, and expanding into new counties in Georgia, North Carolina, and Mississippi. Cigna expects the moves will add about 730,000 more enrollees to its ACA plans.

And when Becerra says ACA enrollees “can find coverage for $10 or less,” he means “less” as in “zero.” About five million uninsured individuals can obtain coverage in an ACA plan for free, partly because of tax credits available for participation in many parts of the country, according to an analysis by the Kaiser Family Foundation.

“Despite most uninsured people being eligible for some form of assistance, either through Medicaid or ACA subsidies, 28 million people remained uninsured in 2021,” the KFF analysis said. “Many uninsured people do not even shop for health coverage, often because of perceptions of high costs. In reality, though, millions of uninsured people are eligible for free plans.”

This year presents an added motivation for signing up for an ACA plan. They offer a replacement to individuals who have gotten insurance coverage under Medicaid because of the expansion of that system under the national public health emergency caused by COVID-19.

Some of those individuals will no longer have the Medicaid option, as the recently passed omnibus bill set a deadline of April 1 for states to begin the redetermination process that will likely disqualify millions for Medicaid.

subsidies for ACA plans