AFFORDABLE CARE ACT SEES NEW ENROLLMENT SURGE
At 11 years old, law is again expanding under White House
More than 200,000 Americans flocked to the Affordable Care Act’s online marketplace to sign up for health insurance during the first two weeks of an open enrollment period created by President Joe Biden — a sign that those who lost insurance during the pandemic remain in desperate need of coverage.
At the same time, a provision in the president’s $1.9 trillion stimulus law to make Medicaid expansion more fiscally appealing has persuaded deeply conservative Alabama and Wyoming to examine whether to expand the government health program to residents who are too rich to qualify now but too poor to afford private health plans.
Eleven years after President Barack Obama signed his signature domestic achievement, and after several near-death experiences, the law is again expanding.
The Biden White House will celebrate Tuesday’s anniversary in a big way. The president will visit Ohio as part of his “Help Is Here” tour to talk up the stimulus law, which greatly expanded subsidies to make insurance affordable for tens of millions of people. And Biden’s newly installed health secretary, Xavier Becerra, whom the Senate confirmed just last week, will travel to Carson City, Nev., to help mark the moment.
The $1.9 trillion “American Rescue Plan” is the first major change to the law since its passage. The new subsidies last for only two years, and it will take some time for the full emergency aid to reach people. Even so, nearly everyone who buys insurance will be eligible to do so at a discount.
But Biden has a new challenge: living up to his campaign promise to expand the law, including making the new subsidies permanent, creating a “public option” for consumers who wish to buy into a government-run insurance plan, and tackling not only the rising cost of health insurance premiums, but also the soaring price of prescription drugs.
“The Affordable Care Act was about trying to create the ground rules so that health insurance was real — it provided real financial security and was affordable — but we’re at this point where we’ve got to address the other side of the equation,” said Frederick Isasi, the executive director of Families USA, a consumer advocacy group that has supported the law.
“We’ve got to address the sector’s pricing abuses, and that’s fundamentally the big question the administration and Congress are facing,” Isasi added. “Are they going to have the political will to do that?”
An estimated 30 million Americans remain uninsured. The Kaiser Family Foundation recently estimated that the number of people with employer-based insurance dropped by 2 million to 3 million from March to September last year. But the foundation has also estimated that 85 percent of those who lost coverage were eligible for either Medicaid or for subsidies under the Affordable Care Act — an option that did not exist during the last major recession.
“This is really the first true test of the ACA,” said Cynthia Cox, who directs a Kaiser Family Foundation program on the law. “In past recessions, you usually see the uninsured rate increase significantly. We don’t know for sure yet, but all indications are that the uninsured rate has not gone up by much, likely in large part thanks to the ACA.”
Expanding access to health care has been a core issue for Biden, both when he was vice president and during his campaign for the White House. When the act was signed into law, he memorably used an expletive to whisper in Obama’s ear that it was a big deal.
A week after he took office, Biden ordered the law’s federally run insurance marketplace to reopen for three months, from February to May 15, to help people struggling to find coverage.
In previous years, Americans in the 36 states that rely on the federal marketplace were eligible to sign up outside the fall enrollment period only if they had “qualifying life events,” including job losses. The current surge in enrollment is more than double the number of people who signed up during the same two-week periods in 2019 and 2020.
During the last open enrollment period, 340,000 new users of the marketplace signed up during the first two weeks. That period ended Dec. 15.
The Affordable Care Act has been under attack from Republicans since its passage, both in the courts and on Capitol Hill, where Republicans tried but repeatedly failed to repeal the measure. The push in the courts did scale back the initial law, when the Supreme Court invalidated its provision requiring states to expand Medicaid.
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