Why a historic 21.3 million people chose insurance in the ACA marketplace?

The Biden-Harris Administration announced that 21.3 million people selected a plan on the Affordable Care Act's Health Insurance Marketplace during the 2024 open enrollment period. The total number of plans selected includes more than five million people - roughly one-fourth - who became new Marketplaces enrollees and 16 million who renewed their coverage. Notably, open enrollment continues through January 31 in four states and Washington, DC.

"For decades, when it came to federal programs we could rely on to keep Americans protected, three - Medicare, Medicaid and Social Security - have always come first, but now it's become abundantly clear that we need to add a fourth - the Affordable Care Act," said HHS Secretary Xavier Becerra. "Once again, a record number of Americans have signed up for affordable health insurance through the Affordable Care Act's Marketplace, and now they and their families can have the peace of mind about their health care that comes with insurance. The ACA continues to be a successful, popular and important federal program for millions of individuals and their families. As we celebrate the success of this latest program, HHS will continue the Biden-Harris Administration's efforts to expand access to quality health care and lower costs."

"These historic enrollment numbers demonstrate the need for comprehensive, quality and 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. "The numbers don't lie: not only is demand for insurance coverage in the marketplaces at record highs, but the marketplaces are delivering on the Affordable Care Act's promise to provide the peace of mind that comes with health insurance for millions of Americans."

The Biden-Harris Administration continues to fulfill its commitment to making health insurance affordable for all, and the Inflation Reduction Act (IRA) and the American Recovery and Reinvestment Act (ARRA) and the American Recovery and Reinvestment Plan continue to keep coverage affordable in the marketplace. Thanks to the IRA, four out of five HealthCare.gov customers were able to find health insurance for $10 or less per month for 2024 after subsidies. In addition, the administration has allocated nearly $100 million for premiums for navigators, allowing organizations to hire staff trained to help consumers find affordable and comprehensive health insurance. Navigators, as they are called, have played a key role in helping consumers in all Marketplace states.

These steps have expanded access to affordable, comprehensive Marketplace insurance coverage for millions of middle- and low-income families across the country. Compared to the open enrollment period last year, nearly 4.2 million people with incomes below 250% of the federal poverty level (about $75,000 a year for a family of four) have enrolled in the 2024 program, showing that when insurance is affordable, people sign up for it. Marketplace insurance is also critical for many people transitioning from Medicaid or the Children's Health Insurance Program (CHIP) as states conduct eligibility renewals, which resumed last year. According to CMS data as of Dec. 31, 2023, in states using the HealthCare.gov website, 2.4 million people, or about 15%, have selected plans previously enrolled in Medicaid or CHIP.

The federal 2024 Marketplace open enrollment period ran from November 1, 2023 through January 16, 2024 for states using the HealthCare.gov platform. Marketplace enrollment deadlines vary by state. The deadlines for each state and other information can be found in the State Marketplace Open Enrollment Fact Sheet - PDF .

There are still opportunities to get coverage after the annual open enrollment period ends. People who are eligible for Medicaid or CHIP can enroll for coverage at any time during the year. For those who are no longer eligible for Medicaid or CHIP, there is a special enrollment period for the Marketplace program. In addition, individuals with incomes less than 150% of the federal poverty level (approximately $22,000 per year for a single person and $45,000 per year for a family of four) can enroll for Marketplace coverage at any time during the special enrollment period. Consumers who have a change in life circumstances - such as marriage, birth of a child, adoption, or loss of qualified health insurance - may also be eligible for a special enrollment period.

The Biden-Harris Administration is encouraging consumers to visit HealthCare.gov to see if they are eligible to enroll in a low-cost, high-quality health plan. Through the provisions of the Inflation Reduction Act, CMS expects that nine out of ten customers will be eligible for savings. Visit HealthCare.gov for more information.

Individuals seeking assistance with insurance enrollment can go to the "Find Local Help" section of the HealthCare.gov website to find a navigator, certified application counselor, and agent or broker.

In addition to the stated choice of plans, New York and Minnesota have a Basic Health Program (BHP) that provides coverage to consumers with family income at or below 200% of the federal poverty level who are not eligible for Medicaid or CHIP and are otherwise eligible for a QHP. As of January 13, 2024, a total of 1,204,722 individuals were enrolled in BHPs in New York. Minnesota BHP data were not available at the time of this report.