Under new American Rescue Plan provisions, record-high 31 million people now covered by Affordable Care Act

June 28 - July 4, 2021

By Wesley Brown

As predicted by President Joe Biden, the $2.2 trillion American Rescue Plan has expanded the number of Americans that now receive health care coverage through the Affordable Care Act, the comprehensive reform measure signed into law by former President Barack Obama in 2010. 

Known commonly and sometimes derisively as Obamacare, the Affordable Care Act helps the uninsured get health insurance by providing them subsidies that help them pay for private insurance. Under former Democratic Gov. Mike Beebe, Arkansas became the first state in the nation to receive approval from CMS to offer health care to newly eligible patients through ACA’s Medicaid expansion. 

The initiative, often referred to as the “private option,” allowed Arkansas to cover close to 220,000 Medicaid beneficiaries. It has since been expanded to more than 900,000 under Gov. Asa Hutchinson, a Republican. The state Department of Human Services manages all Medicaid appropriations from the federal government, including the state’s ACA expansion program now known as Arkansas Health and Opportunity for Me, or ARHOME. 

On June 14, the U.S. Centers for Medicare & Medicaid Services (CMS) released a new report that shows that more than 1 million new and returning consumers now have health coverage through the Health Insurance Marketplace. Under President Biden’s COVID-19 emergency bill approved by Congress on March 11, consumers can purchase health insurance for $10 or less per month after advance payments of premium tax credits (APTC) after April 1, the first day the program began under the new law. 

Of the 1,034,624 consumers who selected a marketplace plan, 687,275 were returning consumers and 347,349 were new consumers, a new CMS report shows. This means 4 in 10 (43%) new consumers and 3 in 10 (30%) returning consumers and more than one third (34%) of all consumers have selected a plan of $10 or less per month under Biden’s rescue plan. 

CMS officials said another 1.2 million Americans have signed up for health insurance since Feb. 15 through HealthCare.gov because of the Biden administration’s Special Enrollment Period (SEP), which has been extended through Aug. 15. In Arkansas, CMS data shows that 11,419 consumers have signed up for healthcare coverage between Feb. 15 and May 31, up 154% from 4492 in the same period of 2020 and 4,045 in 2019.

These numbers reflect new enrollment above and beyond the record-high 31 million people covered under provisions of the ACA, as described in a recent HHS report here: https://aspe.hhs.gov/pdf-report/aca-related-coverage-ib

“Having access to quality, affordable health coverage gives American’s peace of mind when they need to seek care,” said HHS Secretary Xavier Becerra. “Thanks to the Biden-Harris administration’s Special Enrollment Period and expanded premium tax credits from the American Rescue Plan, each week we continue to see more Americans experience the relief and security that comes with affordable, quality health coverage.”

Also, for the first time, the newly released CSM report includes comprehensive demographic data related to gender, race, and ethnicity for consumers who have signed up during the special enrollment period. That demographic data shows that among enrollees who reported a race, 15% were Black compared to an average of about 11% in a similar window in prior years. Among those who reported ethnicity, 18% were Hispanic compared to an average of about 16% in prior years.

“Every American deserves access to high-quality, low-cost health insurance,” said CMS Administrator Chiquita Brooks-LaSure. “The Biden-Harris Administration’s Special Enrollment Period and the American Rescue Plan give the American people a chance to find a quality health care plan that works for them, with costs at an all-time low for millions of Americans. I encourage consumers to visit HealthCare.gov and apply to enroll in a plan before the deadline on August 15.”

Under the American Rescue Plan, Brooks-LaSure said consumers new to the marketplace selecting plans during the special enrollment period, the average monthly premium after APTC fell 26%, from $117 for those enrolling in February and March to $87 for those enrolling in April and May. The new law also lowers out-of-pocket costs for new consumers by making plans with less cost-sharing more affordable after the ARP’s expanded premium tax credits, she said.

The median deductible for consumers new to the Marketplace since February 15 fell by 83%, from $450 prior to April 1 to $75 for consumers new to the Marketplace selecting a plan from April 1 through May 31. Now through Aug. 15, 2021, consumers who want to enroll in coverage, compare plan offerings, or learn if they qualify for more affordable premiums can check their coverage options by visiting HealthCare.gov.

Also, CMS on Monday (June 21) released a new Enrollment Trends Snapshot report showing that over 80 million individuals have health coverage through Medicaid and the Children’s Health Insurance Program (CHIP), a new record.  Nearly 9.9 million individuals, a 13.9% increase, enrolled in coverage between February 2020, the month before the public health emergency (PHE) was declared, and January 2021.

Among the 50 states and the District of Columbia, a total of 80,543,351 people were enrolled and receiving full benefits from the Medicaid and CHIP programs by the end of January 2021. In the 50 states that reported total Medicaid child and CHIP enrollment data for January 2021, over 38.3 million children were enrolled in Medicaid and CHIP combined, approximately 50% of the total Medicaid and CHIP enrollment. 

Biden administration officials said these numbers highlight the essential role the Medicaid and CHIP programs play in providing quality and needed coverage for millions of vulnerable children and adults. In fact, both programs serve as the largest single source of health coverage in the country.

“This report reminds us what a critical program and rock Medicaid continues to be in giving tens of millions of children and adults access to care,” said Bacerra. “This pandemic taught us that now more than ever, we must work to strengthen Medicaid and make it available whenever and wherever it’s needed using the unprecedented investments Congress provided.”

The increase in total Medicaid and CHIP enrollment is largely attributed to the impact of the Families First Coronavirus Response Act (FFCRA), one of the first COVID-19 legislation enacted into law in early 2020. The FFCRA provides states with a temporary 6.2% payment increase in Federal Medical Assistance Percentage (FMAP) funding.  States qualify for this enhanced funding by adhering to the Maintenance of Effort requirement, which ensures eligible people enrolled in Medicaid stay enrolled and covered during the pandemic.

“Medicaid and CHIP serve as a much-needed lifeline for millions of people throughout this country. The increase we are seeing is exactly how Medicaid works: the program steps in to support people and their families when times are tough,” said CMS Administrator Chiquita Brooks-LaSure, part of HHS. “For the parents that may have lost a job or had another life change during the pandemic, having access to coverage for themselves and their kids is life-changing. CMS is committed to ensuring our nation’s marginalized communities and low-income families have the coverage they need.”

To assist states and territories in their response to the COVID-19 pandemic, CMS developed numerous strategies to support Medicaid and CHIP programs in times of crisis, including granting states more flexibility in their Medicaid and CHIP operations. According to the HHS, households earning over 400% above the federal poverty line will now be able to qualify for subsidies. 

However, this will expire in two years unless Congress reauthorizes it. In 2017, Sens. John Boozman and Tom Cotton voted to repeal Obamacare. Congressman French Hill, who represents the 1^st Congressional District that includes Little Rock, also voted to repeal Obamacare along with Arkansas’ three other U.S. House representatives.

Since the COVID-19 was declared a global pandemic in March 2020, both Medicaid and the ARHOME enrollment in Arkansas have jumped substantially around 8% and 23%, respectively, to more than 907,000 people. The total number covered by the Medicaid expansion is more than 317,000, according to latest federal data compiled by CMS. 

PHOTO CAPTION:

U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra formally swears in Chiquita Brooks-LaSure (middle) as Administrator of the Centers for Medicare and Medicaid Services (CMS) on May 27 with husband, Allyn, and daughter, Alexie.