2024 ACA Open Enrollment Period: Enrollment up 30% y/y, New enrollment up 36%
Historic 21.3 Million People Choose ACA Marketplace Coverage
Marketplace enrollment climbs nearly 5 million higher than previous year
The Biden-Harris Administration announced 21.3 million people selected an Affordable Care Act Health Insurance Marketplace plan during the 2024 Open Enrollment Period. Total plan selections include more than five million people — about a fourth — who are new to the Marketplaces and 16 million people who renewed their coverage. Notably, open enrollment continues in four states and Washington, D.C., through January 31.
“For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act,” said HHS Secretary Xavier Becerra. “Once again, a record-breaking number of Americans have signed up for affordable health care coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage. The ACA continues to be a successful, popular, and important federal program to millions of people and their families. As we celebrate the success of this most recent enrollment effort, HHS will double down on the Biden-Harris Administration’s efforts to increase access to quality care and lower costs.”
“These historic enrollment numbers are a testament to the need for comprehensive, quality, affordable health insurance, and we must do everything we can to protect and expand access to coverage for all people,” said CMS Administrator Chiquita Brooks-LaSure. “Numbers do not lie: Not only is demand for Marketplace insurance coverage at an all-time high, but the Marketplaces are delivering on the Affordable Care Act’s promise to provide the peace of mind that comes with having health insurance to millions of Americans.”
The Biden-Harris Administration has continued its commitment to making health insurance available and affordable to everyone, and the Inflation Reduction Act (IRA) and the American Rescue Plan continue to keep Marketplace coverage affordable. Thanks to the IRA, four in five HealthCare.gov customers were able to find health care coverage for $10 or less per month for plan year 2024 after subsidies. Additionally, the administration issued almost $100 million in Navigator Awards, allowing organizations to hire staff trained to help consumers find affordable, comprehensive health coverage. Navigators, as they are known, have been key to helping consumers in every Marketplace state.
These steps expanded access to affordable, comprehensive Marketplace coverage for millions of middle- and lower-income families nationwide. Compared to the Open Enrollment Period last year, nearly 4.2 million more individuals with household incomes less than 250% of the federal poverty level (about $75,000 per year for a family of four) enrolled in 2024 coverage — demonstrating that when coverage is affordable, people sign up. Marketplace coverage has also been critical for many people transitioning from Medicaid or the Children’s Health Insurance Program (CHIP) as states conduct eligibility renewals, which restarted last year. As of December 31, 2023, CMS data show that 2.4 million plan selections in states that use HealthCare.gov, or approximately 15%, were made by individuals who were previously enrolled in Medicaid or CHIP coverage.
The federal 2024 Marketplace Open Enrollment Period ran from November 1, 2023, to January 16, 2024, for states using the HealthCare.gov platform. State-based Marketplace enrollment deadlines vary. State-specific deadlines and other information are available in the State-based Marketplace Open Enrollment Fact Sheet.
Coverage opportunities remain available now that the annual Open Enrollment Period has ended. Individuals eligible for Medicaid or CHIP may enroll in coverage anytime year-round. For those no longer eligible for Medicaid or CHIP, a special enrollment period is available to enroll in Marketplace coverage. Additionally, eligible individuals with household incomes less than 150% of the federal poverty level (approximately $22,000/year for an individual and $45,000/year for families of four) can enroll in Marketplace coverage anytime through a special enrollment period. Consumers who experience a change of life circumstance — such as marriage, birth, adoption, or loss of qualifying health coverage — may also be eligible for a special enrollment period.
The Biden-Harris Administration encourages consumers to visit HealthCare.gov to see if they are eligible to enroll in a low-cost, quality health plan. Because of continuing provisions in the Inflation Reduction Act, CMS expects nine out of 10 customers to be eligible for savings. Visit HealthCare.gov for more information.
Individuals wanting assistance signing up for coverage may go to Find Local Help on HealthCare.gov to find a Navigator, Certified Application Counselor, or agent or broker.
For the snapshot overview, I'm revising the table to compare it against last year. It's important to note the footnote (from the accompanying state by state breakout press release), which notes that this total does not include enrollments after January 13th from 12 of the state-based exchanges, most of which had deadlines later than January 16th and several of which are still open for another week):
Marketplace Enrollment Snapshot Overview:
I don't know how many people have enrolled in these states since Jan. 13th (or how many are still doing so from now through Jan. 31st in the 5 remaining states), but last year these 12 states combined only enrolled around 46,000 more people between Jan. 8th - Jan. 31st, so it's not gonna add more than a nominal number to the final total.
It's also important to note that I've adjusted the 2023 OEP numbers for the fact that Virginia switched from federal exchange (HealthCare.Gov) to state-based exchange (SBM) status this year; I've subtracted the Virginia tally from the 2023 HC.gov totals and added it to the SBM totals for a fair apples to apples comparison.
With the understanding that perhaps ~25,000 (?) or so more enrollees will still be added when the dust settles in all states on Jan. 31st:
- Total enrollment is up over 30% year over year (nearly 5 million people)
- New enrollment up 36%
- Renewals up 29%
- Enrollment up 38%
- New enrollment up 45%
- Renewals up 36%
- Enrollment is up 10%
- New enrollment up 6%
- Renewals are up 11%