Obamacare: Insuring Millions More

A record number of Americans have signed up for Obamacare, with 21.3 million people enrolled for 2024 as of January 24, 2024—a 31% increase compared to the previous year. This is the highest enrolment number since the Affordable Care Act (ACA), also known as Obamacare, was signed into law by former US President Barack Obama in 2010. The ACA helps low- and middle-income Americans access affordable health insurance coverage. As of early 2023, more than 40 million Americans have coverage under the ACA, the highest total on record.

More than 40 million Americans covered under ACA in early 2023

The Affordable Care Act (ACA), often called Obamacare, has provided health insurance coverage to more than 40 million Americans as of early 2023. This is the highest total on record, with nearly 16.4 million consumers selecting or being automatically re-enrolled in health insurance coverage through HealthCare.gov Marketplaces and State-based Marketplaces (SBMs) during the 2023 open enrollment. This is a 13% increase from 2022, and a 36% increase from 2021.

The ACA was implemented in 2014, and since then, enrollment has doubled from 8 million to more than 16 million. The National Health Interview Survey shows that the uninsured rate in the fourth quarter of 2021 was at nearly an all-time low of 8.8% for the full population, compared to 10.3% in the fourth quarter of 2020. The success of the ACA can be attributed to the expansion of Medicaid to low-income adults under 65, with more than 21 million people gaining health care coverage in over 40 states and territories.

The Biden-Harris Administration has celebrated the 13th anniversary of the ACA, highlighting the record-breaking enrollment numbers and lower health care costs due to President Biden's American Rescue Plan (ARP) and Inflation Reduction Act (IRA). The Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure stated that the Biden-Harris Administration has "consistently taken steps to fulfill President Biden's promise to make it easier for Americans to find and enroll in affordable, quality coverage."

The open enrollment period for ACA-compliant health insurance usually runs from November 1 to January 15 in most states, with some states starting earlier or ending later. During the 2023 open enrollment, a record high of 16.4 million people signed up, with 4.4 million more people enrolled since 2021. This includes those who purchased insurance through state-based marketplaces or at HealthCare.gov, the federal government website.

The Department of Health & Human Services (HHS) plays a crucial role in promoting and facilitating enrollment in ACA health insurance plans. They expected 19 million people to sign up by the January 17, 2024 deadline, reflecting a significant increase in Americans securing health insurance coverage.

21 million gained coverage due to Medicaid expansion

The Affordable Care Act (ACA), often called Obamacare, has been a lifeline for millions of Americans, providing them with much-needed health insurance coverage. One of the most significant impacts of the ACA has been the expansion of Medicaid to cover low-income adults under 65. This expansion has resulted in a record-breaking 21 million people gaining healthcare coverage, a truly remarkable achievement.

The success of the Medicaid expansion under the ACA highlights a viable path to affordable and comprehensive healthcare for all. The expansion has been particularly beneficial for low-income adults, a group that often struggles to access essential healthcare services due to financial constraints. By expanding Medicaid, the ACA has ensured that millions of people can now access the healthcare they need without worrying about exorbitant costs.

The impact of the Medicaid expansion has been far-reaching. Since the ACA became law in 2010, 38 states, the District of Columbia, and three US territories have expanded their Medicaid programs to include the adult group. This expansion has not only improved access to healthcare but has also contributed to positive health outcomes and addressed longstanding health disparities.

One of the key benefits of the Medicaid expansion is closing essential coverage gaps for women, who make up more than half of the total adult group. Extending Medicaid coverage to pregnant and postpartum individuals for a full year after pregnancy is a crucial step in addressing disparities and ensuring that women have access to the healthcare they need during and after pregnancy.

The success of the Medicaid expansion under the ACA has been widely recognised. In a statement, Health and Human Services Secretary Xavier Becerra acknowledged the progress made, saying, "With a record-breaking total of over 35 million people who now have health coverage, thanks to the Affordable Care Act, America's uninsured rate is nearing an all-time low. Today's historic reports show we are delivering on our commitment to bring healthcare coverage to as many people as possible."

2024 Obamacare enrolments at a record high of 21.3 million

2024 saw a record-high of 21.3 million Obamacare enrolments, according to the Biden administration. This figure represents a 30% to 31% increase from the previous year, with nearly 5 million more people signing up for Obamacare policies compared to 2023. This surge in enrolment is likely to pose a challenge to former President Donald Trump's promise to repeal Obamacare, as it underscores the public's reliance on and support for the Affordable Care Act.

The significant jump in Obamacare enrolments can be attributed to several factors. Firstly, the Biden administration's efforts to strengthen the law and enhance its appeal played a crucial role. President Biden took steps such as boosting federal premium subsidies through 2025 and allowing more families to qualify for assistance. Additionally, the administration invested over $98 million during the 2023 open enrolment period to support navigators who assist people in finding health coverage.

Another factor contributing to the increase in Obamacare enrolment is the loss of health coverage for millions of low-income Americans who were previously enrolled in Medicaid. As of April 2023, nearly 15.8 million people have been disenrolled from Medicaid due to the expiration of a COVID-19 pandemic relief provision. As a result, many have turned to Obamacare as an alternative source of affordable health insurance.

The surge in enrolment was observed across multiple states, with some witnessing significant increases. Texas led the way with an additional 1.1 million enrollees, followed by Florida with an increase of over 986,000 people. West Virginia and Louisiana also saw notable jumps in enrolment, with increases of around 80% and 76%, respectively.

The high enrolment numbers highlight the critical role of the Affordable Care Act in providing Americans with access to affordable health insurance. With the enhanced subsidies set to expire at the end of 2025, it remains to be seen whether lawmakers will opt to extend these benefits to sustain the gains made in healthcare coverage.

2024 enrolments 33% higher than the previous year

As of early 2023, over 40 million Americans have health insurance coverage under the Affordable Care Act (ACA), also known as Obamacare, the highest total on record. This figure includes those who have bought insurance through state-based marketplaces or at HealthCare.gov, the website run by the federal government.

In 2024, more than 15 million people enrolled in coverage under the ACA by December 15, 33% higher than the roughly 11 million who did so the previous year. The Department of Health and Human Services (HHS) expected this number to surpass 19 million by the deadline of 5 a.m. ET on January 17, 2024, and their coverage to begin on February 1.

On December 15, 2023, more than 745,000 people enrolled in plans on HealthCare.gov, the highest number of visitors ever recorded since the portal launched in 2013. The HHS attributed this surge in enrollment to the continuation of more generous federal subsidies that date back to the coronavirus pandemic.

The success of Obamacare is evident in the record-breaking enrollment numbers, and it continues to be a priority for the Biden-Harris Administration to expand healthcare coverage and lower prescription drug costs.

The individual health insurance market doubled in size by early 2015

The Affordable Care Act (ACA), often called Obamacare, has been instrumental in expanding access to health insurance for millions of Americans. As of early 2023, more than 40 million Americans have gained coverage under the ACA, marking the highest total on record. This represents a significant increase in the number of individuals with health insurance.

The impact of the ACA is particularly evident in the individual health insurance market, which experienced rapid growth in the early years of ACA implementation. By early 2015, the individual health insurance market had nearly doubled in size, reaching almost 20 million enrollees. This surge in enrollment was a notable development, as it indicated a substantial increase from the approximately 11 million individuals who had signed up for coverage before the ACA.

The expansion of the individual health insurance market under the ACA can be attributed to several factors. One key reason was the availability of enhanced subsidies and premium assistance. With the passage of the American Rescue Plan Act (ARPA) and the Inflation Reduction Act, individuals received enhanced financial support, making health insurance more affordable for a larger number of people.

In addition to financial assistance, the ACA also played a crucial role in expanding coverage for low-income adults under 65 through Medicaid expansion. This expansion ensured that underserved communities gained access to healthcare, further contributing to the overall growth of the individual health insurance market.

However, it is important to note that the individual health insurance market has experienced fluctuations since its peak in early 2015. Subsequent declines in enrollment were driven by steep premium increases, particularly among individuals not receiving subsidies. By early 2020, enrollment had decreased to about 14 million. Nevertheless, the overall trend demonstrates the positive impact of the ACA in expanding access to health insurance for millions of Americans.

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