Increased financial assistance from the Inflation Reduction Act drove a record 16.3 million people to select an Affordable Care Act marketplace health plan during the 2023 open enrollment period, the Biden administration announced Wednesday.
“This is more than double the number of Americans who signed up for coverage during the first ever Affordable Care Act Open Enrollment in 2014,” President Joe Biden said in a statement. “And for the more than 30 states that use HealthCare.gov, there has been a combined 50 percent increase in enrollment since I took office in January 2021.”
The 16.3 million is 1.8 million, or 13%, more than last year’s total of 14.5 million sign-ups, and it includes 3.6 million, or 22%, new enrollees for 2023, according to the latest figures from the White House. Another 12.7 million people, or 78% of the 16.3 million, had active 2022 coverage and selected a plan for 2023 or were automatically re-enrolled.
Final sign-up figures are expected to grow even more as enrollment continues through the end of January in several states that operate their own marketplaces for individual coverage. The enrollment period for states using the HealthCare.gov platform ran from Nov. 1, 2022 to Jan. 15, 2023.
“The Biden-Harris Administration has made lowering health care costs and expanding access to health insurance a top priority—and these record-breaking numbers show we are delivering results for the American people,” Health and Human Services Secretary Xavier Becerra said in a statement.
The record-breaking enrollment period was outpacing last year’s sign-up period after just five weeks with 5.5 million plan selections by Dec. 3, 11.5 million selections through Dec. 15, and 15.9 million through Jan. 7, the CMS previously reported.
The American Rescue Plan Act increased ACA premium tax credits and expanded eligibility for the subsidies to people earning above 400% of the federal poverty level for 2021 and 2022. The Inflation Reduction Act continued those expanded subsidies through 2025.
As a result, 80% of enrollees who returned to HealthCare.gov for 2023 could select a plan for $10 or less after the tax credits were applied, the administration estimated.
The expanded tax credits and continuous coverage provisions in the Families First Coronavirus Response Act—which required states to retain all their Medicaid enrollees until the end of the month that the Covid-19 public health emergency is lifted—helped lower the national uninsured rate to an all-time low of 8% in the first quarter of 2022.
Recertifying eligibility for Medicaid beneficiaries, and moving ineligible Medicaid enrollees into new marketplace coverage when the continuous coverage provision is set to expire on April 1, will both be critical in keeping the uninsured rate low.
“We see this as a responsibility on both sides of the house,” CMS Administrator Chiquita Brooks-LaSure said during a press briefing of the work needed by federal and state officials to ensure that people get Medicaid, marketplace, or job-based coverage.