Protect ACA as enrollment grows

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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The glitches accompanying the Affordable Care Act's rollout generated understandable criticism for years after its 2014 debut. But the landmark law's successes deserve the spotlight, too.

This year has brought a milestone worth noting: all-time high enrollment in health plans available through MNsure and other ACA insurance marketplaces nationwide, such as healthcare.gov. That achievement is important for voters to keep in mind as the 2024 election heats up, because consumer-friendly improvements to the ACA could hinge on the outcome. The law's very existence could be in question, too.

In January, Gov. Tim Walz announced that a record number of Minnesotans have signed up for a private health plan through MNsure. Contrary to the still-common misunderstanding that "Obamacare" is a one-size-fits-all government-run plan, MNsure sells policies from UCare, HealthPartners, Medica and other familiar companies. The ACA helps ensure that the plans purchased don't stick consumers with hidden costs. Even more important, the law makes financial assistance available to eligible consumers to instantly discount monthly costs.

Marketplaces like MNsure serve those who buy insurance on their own instead of getting it through an employer or Medicare, the federal program serving seniors. After open enrollment for 2024 coverage ended last month, Walz said that 146,445 Minnesotans had signed up for a private health plan through MNsure. That's a 13% increase from 2023.

National enrollment set a record as well. In late January, the Washington Post reported that over 21 million people had signed up for an ACA plan, an increase of 5 million year-over-year. This is the third straight year of record national enrollment, the story noted.

Numerous factors are driving this, but a key one is a recent change that the Star Tribune Editorial Board has long praised: expanded eligibility for ACA financial assistance. Congress temporarily removed the income cap for this aid during the pandemic and then extended this policy's sunset to Dec. 31, 2025. The change helped many people, such as farmers and entrepreneurs, who had incomes too high to qualify for ACA assistance previously but still struggled to buy a quality health plan.

Congress should keep this expanded eligibility in place after the 2025 sunset. Doing so will require leadership from Congress and the White House. That should help inform voters this fall. Former President Donald Trump unsuccessfully tried to repeal the ACA in 2017. He continues to target the law, announcing late last year on social media that "Obamacare sucks" and he wants to replace it. With what, he didn't say.

Smoothed-out glitches and better public understanding of the law has yielded popular support. Almost 60% of Americans approve of the law, according to 2023 KFF poll. This is the time to protect and strengthen the ACA so that more enrollment records are set and even more Americans can access coverage.