Record 21 million Americans get health coverage through ACA

More than 21 million Americans bought health insurance in the Affordable Care Act Health Insurance Marketplace during the 2024 open enrollment period. That’s according to the Centers for Medicare and Medicaid Services, which noted that was 5 million more sign-ups than in 2023.

The marketplace and the law that created it are sometimes referred to as Obamacare.

In the announcement, the centers said that more than 5 million of the plan enrollments are for people who are new to the marketplace, while 16 million renewed their coverage.

USA Today reported that three states were responsible for half of the national enrollment growth: Florida (4.2 million), Texas (3.48 million) and Georgia (1.3 million).

The article said the states with the biggest percent increase in sign-ups this year were West Virginia (80%), Louisiana (76%), Ohio (62%), Indiana (60%) and Tennessee (59%).

The numbers are expected to climb as open enrollment continues in California, New Jersey, New York, Rhode Island and Washington, D.C., until Jan. 31. For most of the country, the 2024 marketplace open enrollment period was Nov. 1 to Jan. 16.

“Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage,” Health and Human Services Secretary Xavier Becerra said in a written statement. “The ACA continues to be a successful, popular and important federal program to millions of people and their families.”

Added CMS Administrator Chiquita Brooks-LaSure in the same statement, “These historic enrollment numbers are a testament to the need for comprehensive, quality, affordable health insurance, and we must do everything we can to protect and expand access to coverage for all people.”

Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, was among advocates for low-income families hailing the enrollment milestone. She said it “shows the critical role the (Affordable Care Act) plays in filling a coverage gap. Thanks to the expanded premium tax credits extended by the Inflation Reduction Act, more than 20 million people now have the access to health care and financial protection that comes with health insurance.”

She noted, however, that racial, ethnic and geographic lines mean coverage disparities remain.

A controversial program still

The ACA has been controversial since its passage, with people often split along partisan lines. The Washington Post reported Thursday that “the record level of enrollment comes as former President Donald Trump, seeking the GOP nomination, is again vowing to repeal the program if elected.”

Meanwhile, the article quotes President Joe Biden, the other person likely to be on the final presidential election ballot this year, saying, “The American people have made it clear: they don’t want the Affordable Care Act weakened and repealed — they want it strengthened and protected.”

“The sweeping health program — which includes marketplaces for consumers to shop for health coverage, federal incentives for states to expand Medicaid and protections for people with preexisting health conditions — was viewed as President Barack Obama’s signature domestic achievement. It was immediately ensnared in political fights after its 2010 passage, as Republicans campaigned on pledges to ‘repeal Obamacare’ and used the issue to help capture the House in 2010, the Senate in 2014 and the White House in 2016,” The Washington Post article said.

The health insurance program survived several repeal attempts during the Trump administration and polling by KFF, formerly Kaiser Family Foundation, which researches and writes on health policy, found in a May 2023 poll that 6 in 10 American adults view the program favorably.

Special enrollment periods

The marketplace has also been important for many of the people who are transitioning off Medicaid or the Children’s Health Insurance Program amid eligibility reviews, the centers noted. Those folks have a special enrollment period that is still open and households with incomes below $22,000 for an individual and $45,000 for a family of four can access the marketplace at any time. There are also different enrollment options for those who experience a change of life circumstance, including marriage, birth, adoption or loss of qualifying coverage.

For information, visit HealthCare.gov. If you think you need help navigating it, visit  https://www.healthcare.gov/find-assistance/ to find a local “navigator.”