ACA Marketplace Enrollment Up By 33%, Surpassing 19M Enrollees

December 21, 2023 - More than 19 million people have enrolled in Affordable Care Act (ACA) marketplace plans for 2024 coverage, HHS announced.

This figure reflects enrollment data as of December 15, 2023, for states using HealthCare.gov and December 9, 2023, for state-based marketplaces. The 19 million consumers projected to receive marketplace coverage next year is over 7 million more than when President Biden first took office.

The majority of enrollees applied using the HealthCare.gov platform, with 15.3 million people choosing a health plan through the site. December 15 was the deadline for coverage beginning January 1, 2024, and on that day alone, more than 745,000 people chose a plan through HealthCare.gov. This marks the largest single enrollment day in history.

Compared to the same time in 2022, 33 percent more people have enrolled in marketplace plans in states that use HealthCare.gov.

“Millions of Americans signing up for health care coverage under the Affordable Care Act is good news. It means more Americans have the peace of mind of knowing that going to the doctor won’t empty their bank account,” HHS Secretary Xavier Becerra said in the press release. “The Biden-Harris Administration will continue working to expand health care coverage and lower prescription drug costs, so taking care of your health is not a luxury.”

The Inflation Reduction Act extended the enhanced subsidies for ACA health plans until 2025. CMS estimated that nine out of ten consumers will be eligible for savings due to these extensions.

Furthermore, more than 90 percent of HealthCare.gov enrollees will have three or more plans to choose from, according to the press release. The Biden-Harris Administration has created standardized plans that offer similar benefits and cost-sharing amounts, making it easier for enrollees to compare other plan features, such as premiums and provider networks.

CMS has also proposed several changes for marketplace plans that will apply to 2025 coverage options if finalized. The changes would allow states to add routine adult dental services as an essential health benefit and require them to establish quantitative time and distance qualified health plan network adequacy standards similar to those on the federally facilitated marketplace.

The ACA enrollment boost may be due to Medicaid redeterminations, which resumed in April. Since the Medicaid continuous coverage policy ended with the COVID-19 public health emergency this year, at least 12.5 million Medicaid beneficiaries have been disenrolled, according to KFF data.

Many of these disenrollments were due to procedural issues. However, for those who were disenrolled due to losing eligibility, the ACA marketplace remains an alternative source of affordable coverage.