Over 19M could enroll in ACA plans for 2024, CMS says

Dive Brief:

• More than 19 million people could enroll in coverage through the Affordable Care Act marketplaces for 2024, according to preliminary data released Wednesday by the CMS.

• Over 15 million have already picked a health plan using HealthCare.gov. On Dec. 15, more than 745,000 enrolled through the site, making it the largest single day of sign ups in history, according to the agency.

• The update comes after extended pandemic-era subsidies boosted enrollment last year. Medicaid redeterminations, which began in the spring, could also be pushing more people toward the health exchanges.

Dive Insight:

In January, the CMS announced a record-breaking 16.3 million people had signed up for ACA marketplace plans during open enrollment for 2023, as a result of federal subsidies that aimed to protect beneficiaries from premium hikes.

The Inflation Reduction Act, which was passed over the summer last year, extended those subsidies originally enacted by the American Rescue Plan into 2025. Nine out of ten customers should be eligible for savings, the CMS said.

Another factor that could be driving more people toward the exchanges is Medicaid redeterminations.

Beneficiaries were kept continuously enrolled in the safety-net program for low-income people during the COVID-19 pandemic, but states could begin checking eligibility again this spring. More than 13 million people have been disenrolled so far, according to health policy research firm KFF.

Major insurers who sell plans on the marketplaces are also seeing growth on the exchanges, which some argue is a result of former Medicaid beneficiaries looking for new health plans.

During a third quarter earnings call, Molina CEO Joe Zubretsky said special enrollment in its ACA plans had increased to 12,000 a month after the redeterminations process began from an average of 8,000 to 9,000 a month before the unwinding.

Centene also reported member growth in the third quarter, and the insurer expanded its marketplace footprint into 83 new counties for 2024.

The enrollment bump comes as Republican presidential candidates like former President Donald Trump and Florida Gov. Ron DeSantis have renewed criticism for the ACA. Trump said last month he was “seriously looking at alternatives,” while DeSantis said he would pursue legislation to “supersede” the law.

The marketplace open enrollment period ends on Jan. 16.

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