Nov 22, 2022 - Health

ACA sign-ups expected to reach record high, Becerra says

Picture of Xavier Becerra

Photo: Chris Kleponis/CNP/Bloomberg via Getty Images

Enrollment in Affordable Care Act marketplaces is on pace to set a new record, Health Secretary Xavier Becerra told Axios on Tuesday, with subsidies that Congress renewed through 2025 softening the blow of premium increases.

Why it matters: Consumers are flocking to ACA plans as employers and insurers grapple with higher premiums and higher out-of-pocket costs.

By the numbers: Nearly 3.4 million people have signed up for individual coverage between Nov. 1 to 19 — a 17% increase from last year, according to HHS data.

What they're saying: "So far, we're on pace to see another record," Becerra said. "I think we're going to continue to see sign-ups and this may be a very good Christmas for a lot of Americans."

Catch up fast: With the passage of the Inflation Reduction Act, Congress extended enhanced ACA subsidies — premium tax credits and cost-sharing reductions — through 2025.

  • Though lawmakers have resisted making these subsidies permanent, HHS "would encourage Congress to continue to make progress on making health care affordable for everyone," Becerra said.

Between the lines: Enrollment this year comes without the "family glitch," a provision in the ACA that prevented some families from getting subsidized health insurance.

  • But to navigate eligibility requirements, individuals will need information from their employers that the companies are not required to give, potentially adding hurdles, according to a recent Kaiser Family Foundation brief.
  • Becerra told Axios that HHS wants to ensure that the information is available and will make "navigators" available to help people make that decision.

What we're also watching: The ACA markets could become an alternative for some of the millions of Medicaid recipients who are expected to fall off the safety net program's rolls when the COVID-19 public health emergency ends next year.

  • But only about 2.7 million of the approximately 15 million people who are predicted to lose Medicaid eligibility may qualify for a marketplace subsidy, leaving others in danger of going uninsured.
  • It will be a "big priority" for the federal government to work with insurers and local community-based organizations so that people can transition to other health plans, including subsidized ACA plans, said Zach Baron, a health policy and law expert at Georgetown University.

Go deeper: How medical inflation is ensnaring big employers

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