off the charts
POLICY INSIGHT
BEYOND THE NUMBERS

Lower Premiums, More Time to Enroll Will Boost Marketplace Enrollment

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Director of Health Insurance and Marketplace Policy

A new era begins today for people who get their health coverage though the Affordable Care Act (ACA) marketplaces and for many others seeking affordable coverage. The American Rescue Plan’s improvements to financial assistance, plus recent Biden Administration actions, will pave the way for expanded enrollment in comprehensive health coverage that’s more affordable for millions of people. New and current enrollees in HealthCare.gov (the federally run marketplace) can claim the discounted premiums starting April 1.

It’s a sharp departure from four years during which the ACA marketplaces and the law itself were under attack in the courts and Congress and from a hostile Administration. After failing to eliminate the marketplaces and the ACA as a whole, the Trump Administration cut funding for marketing, outreach, and consumer assistance, refused to open the marketplace to emergency enrollment during the COVID-19 pandemic, and discouraged enrollment by increasing red tape.

Now, however, funding is starting to flow to inform the public about their coverage options and help them enroll in marketplace plans. The Biden Administration has extended marketplace enrollment via HealthCare.gov through August 15. And the Rescue Plan has lowered premiums for millions of people who were already eligible for coverage and made 3.6 million uninsured people newly eligible for financial help. Specifically:

  • The vast majority of people previously eligible for a premium tax credit now have lower premiums — $50 lower per person per month, on average. No one will pay more than 8.5 percent of income for a silver “benchmark” plan, and people with lower incomes will pay far less.
  • An estimated 1.8 million uninsured people with the lowest incomes can now get a $0-premium benchmark plan, after counting their premium tax credit.
  • Many middle-income people whose incomes were formerly too high for assistance are now eligible for premium tax credits, which will cap their premium payments at 8.5 percent of their income. This especially benefits older people, who previously had to spend an average of 24 percent of their income on premiums, and people in states with higher premiums.
  • People who have received unemployment benefits in 2021 can now get a $0-premium benchmark plan. They also qualify for the maximum help with deductibles, copayments, and other cost-sharing charges.

In all, 4 in 5 marketplace enrollees can find a health plan for $10 a month or less, and more than half can get a silver plan for $10 or less. This puts coverage in reach for many more of the 15 million uninsured people who are eligible for financial help but not enrolled.

Extending Special Enrollment Period Gives People More Time to Act

With new financial help in the offing, the Biden Administration has extended enrollment at HealthCare.gov through August 15. (States that run their own marketplaces are generally taking similar steps.) Current marketplace enrollees will need this time to return to HealthCare.gov and claim the premium savings; the website is ready to accommodate this starting today. (Enrollees who don’t return will receive their premium discount as a larger tax credit on their next tax return.) People can also newly enroll during the enrollment period, and current enrollees can change plans.

The Biden Administration is supporting this enrollment period with a robust $100 million marketing campaign to bolster consumer awareness — more than ten times the Trump Administration’s spending per open enrollment period. It also boosted funding for navigators, who are trained to help consumers enroll, by $2.3 million and plans further increases this fall.

More than 200,000 people enrolled in the 36 states that use HealthCare.gov in just the first two weeks of the special enrollment period, even before passage of the Rescue Act with its expanded premium tax credits. This suggests enrollment will be robust for 2021 coverage and especially for the 2022 enrollment period this fall, when millions of people will shop for new plans.

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