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Home Affordable Care Act Special Enrollment Period Doubles Enrollees, Final Month Approaches

Special Enrollment Period Doubles Enrollees, Final Month Approaches

3 minute read
by Robert Sheen

In June, the ACA’s special enrollment period garnered 1 million sign-ups through the federal health exchange, HealthCare.gov. A month later and the number of enrollees has doubled.

On July 14, the Centers for Medicare and Medicaid Services (CMS) released new enrollment data that demonstrates more than 2 million Americans have signed up for ACA health coverage through federal and state health exchanges as a result of Biden’s special enrollment period. 

The data reflects enrollment performance from when the special enrollment period first launched in February through June 30. During that time, 1.5 million Americans opted for healthcare coverage through the federal HealthCare.gov platform, and 600,000 collectively obtained coverage through the 15 state-operated health exchanges. 

According to a press release issued by CMS, the new enrollment data “shows that of the new and returning consumers who have selected a plan since April 1, 1.2 million consumers (34%) have selected a plan that costs $10 or less per month after the American Rescue Plan’s (ARP) premium reductions.” In addition, the ARP has allowed 2.5 million Americans to reduce their monthly premiums by 40%, after applying Advanced Premium Tax Credits (APTCs)

New Health and Human Services (HHS) Secretary, Xavier Becerra said, “Let’s be clear – the monthly Marketplace numbers show that across the country, there’s a demand for high-quality, low-cost health coverage. And month after month, we are reminded that the Biden-Harris Administration is fulfilling its promise to deliver access to quality, affordable health coverage by strengthening the Affordable Care Act and pushing its Build Back Better Agenda.”

Conservative states are also experiencing unprecedented enrollment participation as a result of the special enrollment period.

In Texas, nearly 300,000 individuals obtained ACA coverage through the federal health exchange, the second-highest state turnout in the country. The surge in enrollees signals that the Biden administration’s initiatives to create greater access to affordable healthcare are working. 

Despite the shift in enrollment, roughly 4.5 million Texans are still without coverage. If the state were to join the 39 others (including D.C.) in expanding Medicaid, that figure could be cut down significantly, as we’ve seen in Oklahoma and Missouri. Still, the high enrollment figures demonstrate that the ACA is serving the American people well.

Biden’s special enrollment period is currently slated to run through August 15. Between now and then, Americans will be able to obtain coverage at a significantly lower cost through state and federal health exchanges as a result of the ARP. The ARP specifically allows Americans who earn up to 150% of the Federal Poverty Level (FPL) to obtain coverage for $0 monthly premiums and individuals who earn 400% or more of the FPL to obtain coverage for no more than 8.5% of their monthly household income.

The new special enrollment period data aligns with the overall support of the ACA. Last month the healthcare law saw a record-breaking 31 million enrollees and the figures are expected to rise over the next final weeks of the extended enrollment period.

It’s clear then that the ACA is further ingraining itself into the American healthcare system. As part of that system, employers too must offer coverage to their employees as required by the ACA’s Employer Mandate.

Under the ACA’s Employer Mandate, Applicable Large Employers (ALEs) are employers with 50 or more full-time employees and full-time equivalent employees. ALEs 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. Failure to do so subjects them to Internal Revenue Code (IRC) Section 4980H penalties.

Employers that may have been forgoing their responsibilities in anticipation of the ACA being repealed should revisit their processes – the law is not going away, as the Supreme Court recently made final.

If your organization needs assistance complying with the ACA’s Employer Mandate, download the 2021 ACA Essential Guide for Employers to learn what is required of you and how to best mitigate IRS penalty risk.

For information on ACA penalty amounts, affordability percentages, important filing deadlines, steps for responding to penalty notices, and best practices for minimizing IRS penalty risk, download the ACA 101 Toolkit.

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