In celebration of 10 years of ACA marketplaces, the Biden-Harris administration released historical enrollment data
In celebration of 10 years of ACA marketplaces, the Biden-Harris administration released historical enrollment data

Under President Biden, more than 45 million people have coverage thanks to the Affordable Care Act and key actions taken by the administration to strengthen the law

Today, the US Department of Health and Human Services (HHS) issued four new reports showing that President Biden’s efforts to strengthen the Affordable Care Act (ACA) are linked to historic gains in health insurance for Americans. Today’s announcements include a report from the Centers for Medicare & Medicaid Services (CMS) showing that more than 21 million consumers elected or were automatically re-enrolled in health insurance coverage through HealthCare.gov and state marketplaces during the Open Enrollment Period (OEP). in 2024. Three reports from HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) highlight current enrollment trends, enrollment trends broken down by race and ethnicity, and how ACA marketplaces have evolved and strengthened over the first ten years. ASPE’s analysis shows that more than 45 million people have coverage today thanks to the Marketplaces and the Affordable Care Act’s Medicaid expansion.

“On the tenth anniversary of the ACA Marketplaces, HHS is releasing data that shows how profoundly it has changed the way health care looks like for so many Americans. Marketplaces have become a pillar of American society, a guaranteed place where people can find affordable, quality coverage,” said HHS Secretary Xavier Becerra. “Thanks to President Biden’s leadership, more than 21 million Americans have health insurance through the Affordable Care Act’s marketplaces, an all-time high, saving millions of families hundreds of dollars each month.” We at HHS will continue to do everything we can to ensure that more people have access to affordable, high-quality health care and the peace of mind that comes with it.”

“As we look back and celebrate the historic achievements of the Affordable Care Act, the law continues to live up to its goal of providing affordable, quality health care to Americans.” Gone are the days when being a woman was considered a pre-existing condition or sick children could be denied health insurance. Today, more than 100 million Americans have coverage through either the Marketplace or Medicaid, thanks (in part) to increased affordability thanks to the Inflation Reduction Act,” said Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure. “And we won’t stop. Our commitment to strengthening the ACA and increasing access to affordable, comprehensive health care has never been stronger.”

The Biden-Harris administration has taken unprecedented action to make health insurance affordable and accessible to all. National estimates show that most consumers qualify for $0 premiums or save at least $800 a year on their premiums, underscoring the importance of the America’s Savings Plan and the Inflation Reduction Act. Overall, four out of five HealthCare.gov customers were able to choose from health coverage options that were $10 or less per month. In addition, the Biden-Harris administration has allocated nearly $100 million to organizations to hire staff to help consumers find affordable, comprehensive health coverage. Navigators, as they are known, are key to helping users in every country.

Key points from today’s reports include the following.

2024: General Market Plan Selection during the 2024 Open Enrollment Period

  • During the 2024 Open Enrollment Period (OEP), more than 21.4 million consumers elected or were automatically re-enrolled in health insurance coverage through the HealthCare.gov Marketplaces and State-Based Marketplaces (SBMs).
  • 5.1 million more consumers signed up for coverage during the 2024 OEP compared to the 2023 OEP, an increase of 31%.
  • In the HealthCare.gov Marketplaces, 16.4 million consumers selected plans during the 2024 OEP between November 1, 2023 and January 16, 2024.
  • Across the 19 SBMs, 5.1 million consumers selected plans during the 2024 OEP from November 1, 2023 through the end of their respective OEPs.
  • 5.2 million people who signed up for coverage did so for the first time, a 41 percent increase from 3.7 million during the previous OEP.
  • Nationally, 44% of consumers chose a plan for $10 or less per month after APTC during the 2024 OEP.

2024: Affordable Care Act coverage: current enrollment trends and state estimates

  • 18.6 million people have coverage thanks to the ACA’s Medicaid expansion.
  • Across coverage groups, a total of 45 million Americans are enrolled in ACA-linked coverage, the highest total in history. This represents 14.1 million more people enrolled than in 2021 (a 46% increase) and 32.5 million more people enrolled than in 2014 (a 258% increase or more than three times).
  • The study’s results show that all 50 states and the District of Columbia have seen significant decreases in their uninsured rates since 2013, the last year before the ACA was implemented.

2015-2023: ASPE Marketplace Enrollment by Race and Ethnicity Issue Brief

  • The policies of the Biden-Harris administration — such as expanded and improved premium tax credits under the American Rescue Plan and the Deflation Act, and increased coverage of the Marketplace and funding for Navigator — likely contributed to gains in health coverage, particularly among low-income populations. and communities of color.
  • Black Americans and Hispanics continued to enroll in health insurance through the Marketplace at high rates. An estimated 1.7 million blacks and 3.4 million Hispanics enrolled in Marketplace plans in HealthCare.gov states during the 2023 open enrollment period, representing enrollment increases of 95% and 103%, respectively, from 2020 Mr.
  • Asian American, Native Hawaiian, and Pacific Islander (AANHPI) enrollment increased by 14 percent between 2020 and 2023.
  • More than half of black, Hispanic, and Asian American enrollees choose silver plans with cost-sharing discounts, making it the plan most often chosen. These reduced cost-sharing plans allow patients below a certain income to pay less out-of-pocket each time they receive medical services.

2014-2024: How ACA Marketplaces Have Evolved in 10 Years

  • The ACA significantly transformed health insurance by creating health insurance marketplaces where consumers can shop for private comprehensive coverage that meets consumer protection and coverage standards
  • The number of issuers participating in Marketplaces has grown in recent years, giving nearly all Marketplace users (96 percent) a choice of plan offerings from at least three different issuers. This increase in market competition has contributed to premiums that are more affordable for both enrollees and taxpayers. In 2024, 210 health insurance issuers participate in the marketplaces.
  • Between 2013 and the third quarter of 2023, the uninsured rate for all ages fell from 14.4% to 7.7%. Since 2013, the rate of uninsured children has decreased from 6.5% to 3.4% in 2023.
  • The ACA brought key consumer protections, such as preventing consumers from being denied or charged more for coverage because of pre-existing conditions, age and gender.
    • For example, before the ACA, 92 percent of popular plans used a gender rating. A woman can pay up to 81 percent more for the same plan as a man of the same age, even without the plan covering maternity
  • Before the ACA, health plans also often limited the benefits they covered. In 2011, 62 percent of individual market participants did not have coverage for maternity services, 34 percent did not have coverage for substance use disorder services, 18 percent did not have coverage for mental health services, and nine percent of enrollees had no prescription drug coverage.

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