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Home Affordable Care Act ACA Sees Record-Breaking 31 Million Enrollees

ACA Sees Record-Breaking 31 Million Enrollees

3 minute read
by Robert Sheen

A record-breaking 31 million Americans have obtained ACA healthcare coverage, according to new data issued by the Department of Health and Human Services (HHS).

The data, based on enrollment information collected between late 2020 and early 2021, identifies 11.3 million Americans as having obtained coverage through the marketplace and 14.8 million newly enrolled in Medicaid due to the ACA’s eligibility expansion. 

In addition, the report finds that 1 million individuals enrolled in ACA Basic Health Programs, and almost 4 million gained coverage through the ACA’s Medicaid expansion via “enhanced outreach, streamlined applications, and increased federal funding under the ACA.”

It should be noted that the HHS report does not account for recent months of activity. According to an article by HuffPost, “The latest enrollment figures do not include the past few months when Biden reopened enrollment and the Democratic COVID-19 relief bill made that new assistance available.” Healthcare analyst Charles Gaba from tweeted, “the actual total as of TODAY could be as high as 33.5 million…or 10% of the entire U.S. population.”

New HHS Secretary Xavier Becerra tweeted “The historic numbers released today speak to the success of the Affordable Care Act and our country’s need for quality, affordable health care.” In celebration of the high turnout, he added “@POTUS’ American Rescue Plan was a leap forward, and we at @HHSGov will continue to advance the fight for health security.”

In a Zoom call, former President Barack Obama said, “Joe Biden, we did this together,” adding “we always talked about how if we could get the principle of universal coverage established, we could then build on it. And I just want to say how proud I am of what you have done with the American Rescue Plan.”

In reference to Obama’s quote, greater ACA enrollment can be attributed to Biden’s American Rescue Plan (ARP) and its Premium Tax Credit (PTC) eligibility expansion. Under the ARP, Americans with income up to 150% of the Federal Poverty Level can obtain ACA coverage for $0 monthly premiums and individuals who earn 400% and beyond the FPL can obtain coverage at a cost of no more than 8.5% of their monthly household income.

PTC eligibility as adjusted by the ARP is slated to run through the remainder of 2021 and for all of 2022. However, Biden’s American Families Plan proposes making the expansion permanent. Judging by the turnout in ACA enrollment, it appears the move would be widely accepted as Americans continue to leverage the opportunity to obtain quality, affordable coverage.

The high ACA enrollment also coincides with the special enrollment period, which the Biden administration extended through a series of executive orders. Through the special enrollment period, Americans can obtain healthcare coverage through the federal ACA marketplace through August. So far, over 1 million Americans have obtained coverage as a result of the special enrollment period.

The ACA’s success didn’t come easy. Since the healthcare law first went into effect in 2010, it’s been an uphill battle consisting of numerous changes to regulation, lawsuits questioning the constitutionality, and four years of dismantling from the Trump administration. And it’s not quite over either, as the Supreme Court case disputing the constitutionality of the law has yet to be decided. A decision is expected later this month. 

All signs point, however, to the ACA remaining the law of the land and that means continued compliance with the Employer Shared Responsibility Provisions (ESRP), also known as the Employer Mandate.

Under the ACA’s Employer Mandate, Applicable Large Employers (ALEs), which are employers with 50 or more full-time employees and full-time equivalent employees) are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is Affordable for the employee or be subject to Internal Revenue Code (IRC) Section 4980H penalties.

The ACA continues to gain support and employers would be wise to revisit their ACA compliance process, now that the IRS will be ramping up its enforcement efforts. Download the 2021 ACA Essential Guide for Employers to learn about best practices for improving ACA compliance, as well as important filing deadlines, and steps for minimizing IRS penalty risk.

To gain invaluable insights on penalty amounts, affordability percentages, filing deadlines, expert tips for responding to penalty notices, and proven strategies for minimizing IRS penalty risk, download the ACA 101 Toolkit.

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