Note: I'm breaking this analysis into several sections:

Part 1Part 2 / Part 3 / Part 4 / Part 5 / Part 6 / Part 7

Now it's time to move on to the actual demographic breakout of the 2023 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollees.

First up is breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).

Note: I'm breaking this analysis into several sections:

Part 1Part 2 / Part 3 / Part 4 / Part 5 / Part 6 / Part 7

Now that the official press release is out of the way, it's time to dig into the actual final, official state-level data. The table below has the final, official 2023 Open Enrollment Period (OEP) numbers for both Qualified Health Plans (QHPs) in all 50 states + DC as well as Basic Health Plan (BHP) enrollment in Minnesota and New York only, compared to the 2022 OEP.

Note: I'm breaking this analysis into several sections:

Part 1Part 2 / Part 3 / Part 4 / Part 5 / Part 6 / Part 7

via the Centers for Medicare & Medicaid Services (CMS):

Biden-Harris Administration Celebrates the Affordable Care Act’s 13th Anniversary and Highlights Record-Breaking Coverage

A few weeks ago I raised an alarm about the federal budget introduced by former Trump Administration OMB Director Russell Vought's think tank, which is being embraced by many House Republicans as their blueprint for a formal budget proposal.

As I noted at the time, Vought's proposed budget would include, among many other horrific things, completely eliminating funding for the ACA's Medicaid expansion program as well as complete elimination of all Advance Premium Tax Credit (APTC) funding for ACA exchange-based individual market enrollees.

I went on to note that if this proposal were to somehow pass the Senate and be signed into law by President Biden (neither of which is likely to happen, to put it mildly), nearly 40 million Americans would lose healthcare coverage as a result nationally.

Below, I've broken that number out by state to give better context about just how draconian such an eventuality would be.

As I noted a few weeks back, the Patient Protection & Affordable Care Act now directly provides healthcare coverage for a stunning 40 million Americans:'s very likely that another 50,000 - 100,000 people will be added to the final QHP tally when the dust settles tomorrow (Tuesday, January 31st) evening. Even assuming the same 94% effectuation rate, that will still bring the effectuated QHP total to roughly 15.4 million.

Add to this the 1,217,517 confirmed Basic Health Plan (BHP) enrollees in New York and Minnesota and the subtotal comes to around 16.62 million QHPs + BHPs combined.

Next, we need to add Medicaid Expansion enrollees.

...the MBES reports only run through March 2022, at which point the national ACA expansion total stood at 22,275,433.

We're up to 38.9 million Americans with ACA coverage already, and we're still missing a lot of Medicaid expansion enrollees.

Over at Inside Health Policy, Amy Lotven has put together a fantastic roundup of all the stuff going on (or coming up) this year for ACA exchanges and enrollees. I've summarized the key points here, but read the full piece over there if you can (paywalled):

The Medicaid unwinding

The end of the maintenance of effort requirement will be the most significant event for exchange stakeholders in 2023, according to various sources who work closely with health insurance exchanges across the country.

...Estimates of how many people could lose Medicaid benefits and have access to other coverage range from about 15 million to 18 million, and of those about 2.5 million could be eligible for exchange coverage according to recent analyses by HHS and the Urban Institute.

Last spring, I noted that total enrollment in healthcare policies either specifically created by or expanded to more people by the Affordable Care Act had broken 36 million Americans:

The press release talks about "more than 35 million" being enrolled, but when you look at the actual data, it's almost certainly over 36 million as of today. Here's how they break it out:

  • Effectuated ACA exchange enrollment as of March 2022: 13,640,412
  • Medicaid Expansion (newly eligible) as of October 2021: 16,781,800
  • Medicaid Expansion (previously eligible) as of October 2021: 4,261,277
  • Basic Health Plan enrollment as of March 2022: 1,135,190
  • TOTAL: 35,818,679

Notice that even without delving further, the total is already over 35.8 million.

However, there's two important dates to look at here: First, the Medicaid Expansion totals are only up to date as of last October, a good 6 months ago.

Speaker of the House Nancy Pelosi w/Roses

Speaker of the House Nancy Pelosi, the first woman to hold the most powerful position in Congress, who has been the leader of House Democrats for 20 years, announced earlier today that she's stepping down from her leadership position as soon as the 118th Congress takes office on January 3rd, 2023.

Pelosi is a legend in the U.S. Congress, and no accomplishment more perfectly illustrates her skill than the passage of the Patient Protection & Affordable Care Act in 2009 - 2010.

As U.S. Senator Chris Murphy of Connecticut put it in a Twitter thread a few minutes ago:

There's one night I will remember most when thinking about Nancy Pelosi - the night I watched her single handedly save health care for 20 million Americans. It was at the first Democratic caucus meeting after Scott Brown won the special Senate election in Massachusetts.

Many rank-and-file Democrats were in a panic, and they lined up at the microphone to tell Pelosi that it was time for us to give up on the Affordable Care Act. Or chop it up into little pieces - as some in the White House were suggesting.

Via email (no direct link to PR yet):

Tuesday, August 2, 2022

New HHS Report Shows National Uninsured Rate Reached All-Time Low in 2022

Secretary Becerra Says Biden-Harris Administration Efforts to Expand Coverage, Lower Costs through American Rescue Plan and Other Actions Are Working

ACA Signups Logo

Last week the Centers for Medicare & Medicaid posted a new press release about a new report from the HHS's Assistant Secretary for Planning & Evaluation (ASPE) which has updated ACA-specific enrollment data current as of October 2021 - March 2022:

New Reports Show Record 35 Million People Enrolled in Coverage Related to the Affordable Care Act, with Historic 21 Million People Enrolled in Medicaid Expansion Coverage