Obamacare signups near a record 24 million, almost double than when Trump was last in office
Increased funding for outreach has helped drive record interest in Obamacare.
By Tami Luhby, CNN
(CNN) — Obamacare coverage has exploded in popularity during President Joe Biden’s term, fueled by more generous federal subsidies, heightened outreach and an easier enrollment process.
Nearly 24 million people have signed up for Affordable Care Act plans for 2025 so far, and more are expected to choose policies before open enrollment ends on January 15 in most states, the administration announced Wednesday. This includes almost 3.2 million new consumers and more than 20.4 million returning ones.
“That is double the number of Americans who enjoy that peace of mind of having health insurance coverage (than) under the previous administration,” Health and Human Services Secretary Xavier Becerra told reporters. “Four years in a row, we have broken a record in terms of ACA enrollment and health insurance coverage.”
Roughly 12 million people signed up for 2021 coverage during the final open enrollment period of President-elect Donald Trump’s first term, when he unsuccessfully vowed to kill the landmark health reform law and took multiple steps to make Obamacare less attractive and accessible.
But the enrollment gains are at risk: The enhanced federal premium subsidies, which were put in place when Democrats controlled Congress earlier in Biden’s term, are set to expire at the end of 2025. It will be up to Trump and the Republican-led Congress to decide whether to extend them.
During the 2024 presidential campaign, Trump initially signaled that he would once again consider terminating the Affordable Care Act. But he later shifted to saying that he would run Obamacare “as good as it can be run” while coming up with a better plan, without providing details.
More people insured
The growth in Obamacare enrollment, along with boosts in Medicaid and Children’s Health Insurance Program coverage, helped drive down the uninsured rate to record lows during Biden’s term, according to the Department of Health and Human Services. The rate was 7.6% in the second quarter of 2024.
More than 300 million Americans have health insurance coverage, including more than 100 million folks through the Affordable Care Act, Medicaid and CHIP programs.
Low-income Americans, who can obtain plans with no or very low premiums thanks to the enhanced subsidies, have primarily spurred the growth in enrollment in Obamacare plans, according to a 2024 report by KFF, a nonprofit health policy research group. The temporary subsidies also make health insurance policies more affordable for the middle class, increasing their enrollment, too.
The beefed-up Obamacare subsidies have allowed four out of five consumers to find plans for $10 or less a month. Enrollees save an average of $800 a year on their premiums.
In addition, the Biden administration has greatly boosted funding for outreach and enrollment assistance. And it has increased the use of external data sources to verify consumers’ incomes, reducing the documentation that some people must file. This has led some Republicans to charge that subsidies are going to enrollees who aren’t eligible, inflating enrollment.
If the expanded subsidies are allowed to expire, 4 million people would become uninsured, according to an Urban Institute analysis.
Extending the subsidies, however, would cost $335 billion over 10 years, according to the Congressional Budget Office. Their expiration comes at a time when congressional Republicans are trying to find ways to reduce spending to help offset the cost of extending their 2017 tax cuts.
In the call with reporters, Biden administration officials urged GOP lawmakers to renew the enhanced subsidies, noting that without them, premiums could rise for a single parent by at least $1,500 and for a retired couple by $18,000.
“Congress faces a choice this year. If they do not extend the enhanced premium tax credits that were passed through the Inflation Reduction Act and through the ARP (American Rescue Plan) before that, costs will essentially skyrocket for millions of Americans,” Neera Tanden, White House domestic policy advisor, told reporters. “The results would be catastrophic.”
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