The Department of Health and Human Services
announced on Wednesday that more than 2 million people
have signed up for insurance
through the Affordable Care Act
's online marketplaces since Feb. 15, taking advantage of the Biden administration
's extended period for open enrollment that began on that day.
That figure indicates that total marketplace enrollment is likely to be at an all-time high, while the number of uninsured Americans is likely to be at an all-time low, with a major reason being a set of temporary improvements to the Affordable Care Act that President Joe Biden
are now attempting to make permanent.
According to HHS, approximately 600,000 Americans have signed up for insurance through state-run marketplaces such as Covered California
, while 1.5 million have obtained coverage through HealthCare.gov, the website that the federal government operates on behalf of the remaining states
Enrollment in these online marketplaces, which are part of the health care law
known as Obamacare
, increased for the Affordable Care Act's first three years of operation, swelling to about 12.7 million in 2016, then dipped slightly until 2020, when it began to increase again, most likely as a result of the economic downturn from the Great Recession.
This occurred despite overt hostility from Donald Trump
, who as president led Republican
efforts to repeal the Affordable Care Act. Biden, who famously called the health-care overhaul a "big f**king deal
," has taken a number of executive actions designed to bolster the program, one of which was an extension of "open enrollment" at HealthCare.gov, which began on Feb. 15 and is set to last until the end of the year.
The American Rescue Plan
, a COVID-19
relief bill passed by Democrats and signed by Biden in early 2021, made the program much more generous by making more people eligible for financial assistance and increasing assistance for those who already qualified.
For some insurance buyers, the differences are quite dramatic, amounting to hundreds, if not thousands, of dollars per year, resulting in lower premiums, allowing some people to afford more generous plans.
“The American Rescue Plan has made health coverage more affordable and accessible than ever before, and people are signing up,” said Chiquita Brooks-LaSure, who oversees the Affordable Care Act marketplaces as the chief administrator for Medicare
According to experts, a large proportion of those enrolling now would not have had insurance otherwise, and the number of uninsured Americans is decreasing.
“There is no doubt
that the reopening of ACA enrollment and increased premium assistance under the American Rescue Plan are reducing the number of uninsured people,” Larry Levitt, executive vice president of the Henry J. Kaiser Family
Foundation, told Stardia on Wednesday, adding that “many people who were already insured are also seeing their premiums drop.”
The new financial assistance means that the Affordable Care Act now more closely resembles the program's original vision, prior to political compromises that limited the program's reach.
However, because it is a COVID-19 relief measure, the new assistance is only temporary and will expire after next year unless Congress
Biden and Democrats are attempting to accomplish this by incorporating an extension of the subsidies into the large spending bill they hope to pass later this year.
Even with the increased financial assistance, many millions of people continue to struggle with the cost of insurance and health care, and many millions remain uninsured entirely, a problem that Biden and Democrats are attempting to address through a variety
of measures that could also be included in the spending bill.
Proposals to close the "Medicaid gap" are among the issues being debated.
Originally, the Affordable Care Act was intended to make all low-income Americans eligible for state Medicaid programs; however, Republican officials in a dozen states have refused to expand their programs, despite the fact that the federal government would cover the majority of the cost, citing both philosophical objections to more government-sponsored insurance and a belief that even the smallest state contribution would be insufficient.
This decision has resulted in several million uninsured poor Americans in states such as Florida
, and Democrats are now looking into ways to directly cover those people through a new federal program.
A proposal to add dental, vision, and hearing benefits to Medicare is also being considered, which would provide relief to senior citizens who are burdened by these costs.
As is always the case in health policy, all of these initiatives would entail trade-offs, one of which would be cost, as each of these initiatives would necessitate hundreds of billions of dollars in new spending over the next ten years.
Democrats have stated that they intend to fund new health-care initiatives primarily through a combination of new taxes
on the wealthy and new federal drug-pricing regulation, which would reduce government spending.
However, each of these proposals has its own set of trade-offs and political opponents.