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ACA Marketplace Enrollment Tops 21 Million, Nearly 5 Million More than 2023

Insurance Forums Staff

The Biden-Harris Administration announced this week that 21.3 million people selected an Affordable Care Act Health Insurance Marketplace plan during the 2024 Open Enrollment Period.

Total plan selections include more than five million people—about a fourth—who are new to the Marketplaces and 16 million people who renewed their coverage.

Notably, open enrollment continues in four states and Washington, D.C., through January 31.

“For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind—Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth—the Affordable Care Act,” said HHS Secretary Xavier Becerra. “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. The ACA continues to be a successful, popular, and important federal program to millions of people and their families.”

“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,” said CMS Administrator Chiquita Brooks-LaSure. “Numbers do not lie: Not only is demand for Marketplace insurance coverage at an all-time high, but the Marketplaces are delivering on the Affordable Care Act’s promise to provide the peace of mind that comes with having health insurance to millions of Americans.”

In a Jan. 24 CMS press release announcing the enrollment numbers, the Inflation Reduction Act (IRA) was credited with continuing to keep Marketplace coverage affordable. Because of the IRA, four in five HealthCare.gov customers were able to find health care coverage for $10 or less per month for plan year 2024 after subsidies.

HealthSherpa CEO George Kalogeropoulos recently posted on LinkedIn that his company has enrolled over 7 million people for Plan Year 2024, with over 62% paying nothing for coverage.

Additionally, the administration issued almost $100 million in Navigator Awards, allowing organizations to hire staff trained to help consumers find affordable, comprehensive health coverage. Navigators, as they are known, have been key to helping consumers in every Marketplace state.

These steps expanded access to affordable, comprehensive Marketplace coverage for millions of middle- and lower-income families nationwide. Compared to the Open Enrollment Period last year, nearly 4.2 million more individuals with household incomes less than 250% of the federal poverty level (about $75,000 per year for a family of four) enrolled in 2024 coverage.

The press release noted Marketplace coverage has also been critical for many people transitioning from Medicaid or the Children’s Health Insurance Program (CHIP) as states conduct eligibility renewals, which restarted last year. As of December 31, 2023, CMS data show that 2.4 million plan selections in states that use HealthCare.gov, or approximately 15%, were made by individuals who were previously enrolled in Medicaid or CHIP coverage.

The federal 2024 Marketplace Open Enrollment Period ran from November 1, 2023, to January 16, 2024, for states using the HealthCare.gov platform. State-based Marketplace enrollment deadlines vary. State-specific deadlines and other information are available in the State-based Marketplace Open Enrollment Fact Sheet.

Coverage opportunities remain available now that the annual Open Enrollment Period has ended. Individuals eligible for Medicaid or CHIP may enroll in coverage anytime year-round. For those no longer eligible for Medicaid or CHIP, a special enrollment period is available to enroll in Marketplace coverage.

Additionally, eligible individuals with household incomes less than 150% of the federal poverty level (approximately $22,000/year for an individual and $45,000/year for families of four) can enroll in Marketplace coverage anytime through a special enrollment period. Consumers who experience a change of life circumstance—such as marriage, birth, adoption, or loss of qualifying health coverage—may also be eligible for a special enrollment period.

Because of continuing provisions in the Inflation Reduction Act, CMS expects nine out of 10 customers to be eligible for savings. Visit HealthCare.gov for more information.


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