14.5M get health care under ACA

At least 14.5 million Americans are getting private health insurance for this year under the Obama-era health law, thanks to help from the Biden administration.

"Health care should be a right, not a privilege, for all Americans," President Biden said Thursday in a statement announcing the numbers. "We are making that right a reality for a record number of people, bringing down costs and increasing access for families across the country."

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But progress could prove fleeting if congressional Democrats remain deadlocked over Biden’s social agenda package. Biden’s earlier coronavirus relief bill has been providing generous subsidy increases that benefit new and returning customers by lowering premiums and out-of-pocket costs. The enhanced financial assistance is temporary. It will go away at the end of 2022 without congressional action to extend it additional years or make it permanent, included in the social agenda legislation.

Separately, the Department of Health and Human Services said the latest information from a major ongoing federal survey suggests that the nation’s uninsured rate dipped last year, as the Biden administration provided a special sign-up period due to the pandemic. The uninsured rate was 8.9% in the three-month period from July to September 2021, compared with 10.3% for the final three months of 2020.

"Those are all arrows ... in the right direction," HHS Secretary Xavier Becerra said.

The ACA, better known as "Obamacare," offers health insurance to people who lack job-based coverage through a mix of subsidized private plans and expanded Medicaid, which is provided in most states. Thursday’s numbers reflect the private insurance side of the program, available in all states through HealthCare.gov or state-run health insurance markets. All told, the number of people covered though the Obama law is estimated around 30 million.

"This did not happen by accident," Biden said. His COVID-19 relief bill, he said, "did more to lower costs and expand access to health care than any action since the passage of the Affordable Care Act."

Besides improved subsidies, the Biden administration also focused more attention on outreach, increasing the number of enrollment counselors and stepping up advertising.

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"When we invest in health care and make it affordable, people sign up," said Chiquita Brooks-LaSure, head of the Centers for Medicare and Medicaid Services, which also oversees the ACA.

The administration is touting the 14.5 million sign-ups as a record, but that number is not strictly comparable to recent years because the federal open enrollment season was extended under Biden. The final number is likely to be even higher as several states are allowing residents to sign up until next Monday. It’s working out to an increase of roughly 20% over last open enrollment season.

Some Democratic senators are expressing confidence that Congress will pass the extension of health care subsidies that Biden is calling for, thus preserving the momentum from this year’s sign-up season. Although divisions among Democrats are holding up the Biden social agenda bill, health insurance is one area in which major disagreements haven’t broken out.

"We’re in the process now of talking that through, and we’re pushing very hard to include this extension of premium support," Sen. Chris Van Hollen, D-Md., said Thursday. "In my view, that’s a priority."

"We feel very strongly about the health care package," Sen. Ron Wyden, D-Ore., said earlier in the week. "I feel confident we’ve got 50 votes on those issues."

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In the evenly divided 100-member Senate, Democrats need every member of their caucus, plus Vice President Harris to cast the tie-breaking vote.

Biden wants to move the U.S. closer to coverage for all by building on existing programs like the Obama law and Medicaid, so a robust sign-up season was a priority for his administration.