December 7, 2023


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More than 200,000 Americans sign up for ACA health plans during special enrollment period

But the demand for ACA health plans during this early phase of the unprecedented three-month enrollment extension was a fraction of the enrollment during the first two weeks of the most recent regular enrollment time, when 1.6 million Americans signed up during the first half of November.

Ordinarily, the federal ACA insurance marketplace is open mainly during an annual enrollment season — a six-week period near the end of the year during the Trump administration. The rest of the year, consumers have been able to buy an ACA health plan only if they secured special federal permission because of a major change in life circumstances, such as the birth of a child, a move or a lost job.

Last spring, many health policy experts and consumer-health advocates pressed President Donald Trump to throw the doors wide open to as the economic dislocation resulting from the pandemic was starting to cost people their jobs and the health benefits that came with them. Trump refused, and he refused again to leave the insurance marketplace open longer late last year.

Days after he was sworn into office in January, Biden directed health officials to reopen the online federal insurance marketplace for three months, until mid-May. The executive order he issued was a down payment on his oft-stated goal of making health care affordable and accessible to more Americans. He advocates using the ACA, a sprawling 2010 health-care law passed while he was vice president to President Barack Obama, as the lever to expand coverage.

In a statement Wednesday, Biden said, “These numbers are an encouraging sign — but we can’t slow down until every American has the security and peace of mind that quality, affordable health coverage provides.”

He gave a plug for people to enroll while they can. “There is plenty of time left to sign up, and I encourage everyone who needs health insurance to go to before May 15,” the president said. “If you already have coverage, you can help family members and friends who are uninsured get themselves covered.”

Biden also gave his latest pitch for coronavirus relief legislation, passed by the House and now before the Senate. Among other things, the package would increase subsidies — received by nearly 9 in 10 people who have ACA health plans — to help pay monthly insurance premiums. The first upgrade in subsidies since the insurance began in 2014, the legislation also would expand the pool of people eligible for the financial help to those in the middle class and provide more assistance to people claiming unemployment insurance.

Outside health policy specialists have predicted the greater financial help would significantly boost sign-ups during the extended enrollment time.

The insurance sold through federal and state ACA marketplaces is intended for Americans who cannot get affordable health benefits through a job. Three dozen states rely on, while the rest run their own insurance exchanges. Over the years, debate has raged over whether they are affordable, with Republicans lambasting them as too expensive as the GOP has worked to dismantle much or all of the law.

Department of Health and Human Services spokesman Sean Higgins said Wednesday that national network and cable advertising began Feb. 15 and will air throughout the extended sign-up. Some cable and digital ads are targeted to Black and Latino communities — in Spanish and English. Digital advertising is running in all three dozen states relying on, Higgins said.

The administration, however, did not initially provide extra money to community groups that serve as enrollment coaches, known as navigators. This week, health officials announced they were giving the navigators a relatively small extra amount — $2.3 million for the rest of the extended sign-up time.

The leader of a large navigator in Florida said this week that the group’s volume of calls since the marketplaces reopened was running similar to that of late last year. The head of a Wisconsin navigator said, however, that the sign-up period has been relatively quiet.