Holiday cheer: Affordable Care Act smashes enrollment records 


December 23, 2021

Omicron is surging and the Build Back Better Act is stalled. Yet there is some really good news to report this holiday season: a record 13.6 million Americans have signed up for individual coverage under the Affordable Care Act, and that number is only going to increase over the next three weeks. 

Back in March, Congress passed and President Biden signed the American Rescue Plan. That legislation increased the premium subsidies U.S. citizens can receive under the ACA and expanded the number of people who can get assistance by raising income ceilings.  

That legislation increased the premium subsidies U.S. citizens can receive and expanded the number of people who can get assistance by raising income ceilings. On Wednesday, the Centers for Medicare & Medicaid Services announced that more than 9.7 million Americans enrolled in coverage in the 33 states using for 2022 from the start of open enrollment through December 15. “This is over 900,000 more people than the previous all-time high of 8.8 million who signed up during the 2018 Open Enrollment with 39 states using,” CMS said. 

Meanwhile, the 18 state-based marketplaces (SBMs) that have their own sign-up platforms reported “almost 3.9 million consumers selected plans or were automatically re-enrolled in a plan for 2022 health coverage” through December 11, CMS announced. “This is up from last year when SBMs reported that 3.4 million consumers made a plan selection in the 15 state-based marketplaces for 2021, through week six.” 

The numbers will go up further for two reasons. First, Wednesday’s announcement only covered enrollees through December 15, meaning the data already was a week old. Second, Americans have until January 15 to sign up for coverage. 

“The historic 13.6 million people who have enrolled in a health insurance plan so far this period shows that the demand and need for affordable health care remains high,” U.S. Health and Human Services Secretary Xavier Becerra said in a statement. “Thanks to President Biden’s American Rescue Plan, more people today have affordable coverage – and we aren’t finished yet: people still have time to sign up and get covered before the January 15 deadline. This holiday season, let’s share the peace of mind that comes from having coverage.” 

According to CMS, the Biden Administration is getting the word out to make sure people know about the enhanced financial assistance available under the American Rescue Plan. The agency said 1,500 “Navigators” are helping consumers enroll in communities across the country. For example, Navigators in Kansas recently attended a fall festival and movie night hosted by the Boys & Girls Club and handed out educational information about Open Enrollment, answered questions from consumers, and scheduled appointments for enrollment assistance. CMS says it is concentrating outreach on those most in need of health coverage who historically have lacked access. 

In addition to relief provided by the American Rescue Plan, experts say two other factors have contributed to the surging enrollment numbers. First, the Biden Administration invested much more heavily in advertising than its predecessor, which drastically reduced outreach in the hope of undermining the ACA. And second, the pandemic caused a disruption in many employer-based health plans. 

According to the New York Times, the increased enrollment, covering at least two million more Americans than in any previous year, was particularly heavy in states such as Georgia and Texas that have high numbers of uninsured families and declined to expand Medicaid to cover people with low incomes. 

“What a great day it is to really see how the programs are working as they are intended,” CMS Administrator Chiquita Brooks-LaSure told reporters on a conference call. 

Affordable Care Act
American Rescue Plan