Nearly 24 million consumers have picked an Affordable Care Act health insurance plan for 2025, breaking last year’s record enrollment, even though consumers have another week to sign up for coverage this year, Biden administration officials announced Wednesday.
The number of signups this year surpassed last year’s record of 21.4 million people. And consumers have through Jan. 15 to select a health insurance plan from the federal marketplace, Healthcare.gov, according to the Centers for Medicare & Medicaid Services.
The record signups have been buoyed by the generous subsidies Congress passed during the COVID-19 pandemic, but outgoing Biden administration officials warned there’s no guarantee they’ll be extended beyond the end of this year.
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“Our efforts to lower healthcare costs and expand coverage are in jeopardy,” Neera Tanden, the White House’s director of domestic policy council, said on a Tuesday call with reporters. If the Republican-controlled Congress doesn’t extend the enhanced subsidies beyond this year, “cost will essentially skyrocket for millions of Americans. The results would be catastrophic.”
Enhanced ACA subsidies expire next year
The Affordable Care Act, often called Obamacare, has always given taxpayer-subsidized credits to consumers based on their income levels to offset the cost of monthly health insurance premiums. Those subsidies became more generous under the American Rescue Plan Act in 2021 to ensure more Americans were covered during the COVID-19 pandemic. In 2022, the Inflation Reduction Act extended those subsidies through 2025.
So while health insurance costs have risen, consumers can still get sharply discounted insurance. Biden administration officials said 80% of consumers can get a health plan for $10 or less per month.
If the enhanced credits aren’t extended beyond 2025, consumers’ portion of their monthly insurance bills would increase more than 75% and rates in some states would more than double, according to an analysis by KFF, a health policy nonprofit.
In a statement, President Joe Biden touted his efforts to shore up ACA coverage, noting enrollment has nearly doubled since he took office.
“I urge Congress to double down on the progress we have made and ensure Americans have access to quality, affordable health care by extending the ACA premium tax credit this year,” Biden said.
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What will Trump do?
While it’s unclear how President-elect Donald Trump will approach the Affordable Care Act when he takes office later this month, he pushed unsuccessful efforts to repeal and replace the 2010 health care law during his first time. The Trump administration also expanded the use of short-term health insurance plans, which offered limited benefits and less expensive monthly premiums but denied coverage for existing medical conditions.
In his first term, Trump also cut the marketing outreach budget for navigators who help consumers sign up for marketplace insurance or Medicaid, the federal health care program for low-income families that was expanded in most states with funding from the ACA.
Brian Blase, a White House adviser during the Trump administration who runs the conservative think tank Paragon Health Institute, noted the record signups last year came amid consumer complaints that some were being switched from one plan to another without their permission.
“Unfortunately, the plans offer such low value that roughly half of enrollees need to receive giant subsidies that cover the entire premium cost in order to enroll,” Blase said.
Republican Attorney Generals in 19 states sued to block the Biden administration’s efforts to extend ACA coverage to people under the Deferred Action for Childhood Arrivals, or DACA, an Obama-era executive action that protected undocumented immigrants who arrived in the United States as children from deportation. DACA members, sometimes referred to as Dreamers, who number about 530,000, are still allowed to sign up for ACA coverage in 31 states.
“For the first time ever, and despite pending litigation, DACA recipients … in 31 states can sign up for affordable marketplace coverage,” said Xavier Becerra, secretary of the U.S. Department of Health and Human Services. “Very proud of that.”
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