Americans are signing up for Obamacare in record numbers

Despite a recent warning from former President Donald J. Trump, the front-runner in the race for the 2024 Republican presidential nomination, that he was “seriously looking at alternatives” to the Affordable Care Act, the latest surge in enrollment in the market is a testimony. to the lasting power of the law.

Legislation passed earlier during the Covid-19 pandemic increased federal subsidies for people buying plans, lowering costs for many Americans. The Biden administration also lengthened the enrollment period and increased program advertising and funding for so-called navigators that help people enroll.

“More and more people are realizing they can enter the market,” said Cynthia Cox, director of the Affordable Care Act Program at KFF, a nonprofit health policy research group.

He added: “Just because the ACA has been around for a while doesn’t mean people who need to sign up know how to do it.”

On Dec. 15, the deadline to sign up for coverage that begins Jan. 1, nearly 750,000 people opted for a marketplace plan on It was the highest single-day total so far.

Dr. Benjamin Sommers, a Harvard health economist who worked in the Biden administration, said better outreach helped explain the record enrollment. “I’m pleasantly surprised,” he said.

With years of rising subsidies, he added, “it could be that this is the natural growth rate in a few years in a new policy environment.”

Kody Kinsley, North Carolina’s top health official, said his state had gotten creative in using its efforts to expand Medicaid to also enroll people in marketplace plans.

“We have had a very extensive educational and outreach campaign, with civic organizations, churches and boaters, built around the expansion to educate people about eligibility,” he said in a text message.

He added: “As part of that, we support people to get coverage in the marketplace, if they are not eligible” for Medicaid.

The open enrollment period on runs through mid-January and ends at 5 a.m. ET on January 17. People who sign up by then will have coverage starting in February.

Biden administration officials said they were encouraging enrollees already covered through to continue shopping for plans, in case a new option turns out to be better and more affordable.

The Affordable Care Act marketplaces have become particularly valuable to people who lose Medicaid coverage this year after a federal policy that guaranteed coverage early in the pandemic expired in April.

The millions of people leave Medicaid lists has contributed to increases in marketplace enrollment, Cox said, and to surges during typically quieter periods outside of open enrollment. (TRUE life eventssuch as the sudden loss of other health coverage, allow some Americans to get new plans outside of the open enrollment period).

According to federal health officials, from March to September enrollment in marketplace plans increased by 1.6 million people, or 1.5 million more than during the same period last year.