I don’t know that we would have predicted this a decade ago but I’m sure there’s a lesson in that somewhere:
A record number of Americans — 13.6 million — have signed up for health plans through the Affordable Care Act’s marketplaces for 2022. The major reasons for the rise appear to be: Congress lowered the cost of Obamacare insurance; the Biden administration increased advertising for the program; and the pandemic disrupted many Americans’ employer-provided coverage.
The Covid-19 public health emergency helped usher in an era of greater generosity and expanded outreach to the uninsured that many of Obamacare’s original authors had long called for.
The increased enrollment, covering at least two million more Americans than in any previous year, was particularly pronounced in states like Georgia and Texas that have high rates of uninsurance and declined to expand Medicaid to cover their poorest adults.
“What a great day it is to really see how the programs are working as they are intended,” Chiquita Brooks-LaSure, the administrator for the Centers for Medicare and Medicaid Services, told reporters on a conference call.
The Biden administration has invested heavily in promoting the availability of insurance subsidies under the Affordable Care Act. It also quadrupled the network of professionals available to help people enroll. But Ms. Brooks-LaSure said she thought the main driver of the enrollment increase was the lower prices most Americans would pay.
A stimulus bill passed by Congress in March made many more Americans eligible for financial assistance in buying Obamacare plans. For most people with low incomes, comprehensive coverage is currently available for no premium. Some middle-class people earning higher incomes became eligible for subsidies for the first time.
Taken together, the policies have represented an expansion and a reimagining of the Affordable Care Act, what some policy experts have called Obamacare 2.0. The enrollment numbers suggest that these changes have substantially increased enrollment in the program, counteracting coverage declines from falling employment during the pandemic.
That is really good news. Unfortunately the expanded benefits only go through 2022 and the needed extension is in the Build Back Better Bill that Joe Manchin and Kyrsten Sinema have personally sabotaged. So we’ll have to see.
Still it’s great news. America can’t seem to get much done anymore but this was an imperfect achievement that seemed precarious at the moment but which has hung on and seems safe, at least in some form. We shouldn’t have to fight so hard for things like this but we do. And it’s worth it.