May 7, 2021 - Health

Enrollment surge may help Democrats' push for ACA changes

People lined up to go into a building in the shape of a health care cross

Illustration: Lazaro Gamio/Axios

Democrats’ big investments in the Affordable Care Act appear to be paying off.

Driving the news: Almost 1 million Americans have signed up for ACA coverage since February, roughly half of them in April alone, the Centers for Medicare & Medicaid Services said yesterday.

Why it matters: The strong enrollment numbers could help Democrats make the case that some of their changes to the ACA should become permanent.

  • "The success of the ACA enrollment period has significance for the people who get newly covered or see their premiums or deductibles go down. It also has political significance for the Biden Administration, looking to build support for a permanent increase in premium subsidies," KFF executive vice president Larry Levitt tweeted.

What's happening: In its early days, the Biden administration created a special enrollment period that allows people to sign up for ACA coverage until the end of April.

  • And a temporary expansion of the ACA's premium subsidies, passed as part of coronavirus relief legislation, kicked in April 1.

By the numbers: The bigger subsidies have saved Americans a lot of money, according to CMS.

  • People who enrolled after April 1 are paying, on average, 25% less in premiums than people who signed up in February or March. Deductibles were about 90% lower for people who signed up after the bigger subsidies took effect.
  • About 2 million people have seen their premiums fall after going back through the system to recalculate their costs after April 1, CMS said. The average savings for that group was 40%.

What's next: The premium bump lasts for two years, but the Biden administration is looking to make it permanent.

What they're saying: "It’s not just large numbers, it’s increasingly large numbers and ... it’s also validating what we always knew: That affordability was a primary barrier to people uninsured and other people who require care," Democratic health strategist Chris Jennings tells Axios.

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