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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, DC, 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 don’t 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 shows 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 runs 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 circumstances — 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: https://www.healthcare.gov/find-assistance/.

Marketplace Enrollment Snapshot Overview:
Marketplaces and Consumer Types Cumulative 2024 OEP Plan Selections
Total: All Marketplaces 21,310,538
New Consumers 5,045,290
Returning Consumers 16,265,248
Total: HealthCare.gov Marketplaces 16,363,133
New Consumers 4,226,461
Returning Consumers 12,136,672
Total: SBMs1 4,947,405
New Consumers 818,829
Returning Consumers 4,128,576

1 In addition to reported plan selections, New York and Minnesota have a Basic Health Program (BHP), which provides coverage to consumers with household incomes at or below 200% of the federal poverty level who are not eligible for Medicaid or CHIP and would otherwise be eligible for a QHP. As of January 13, 2024, New York had a total of 1,204,722 individuals enrolled in a BHP. Minnesota’s BHP data was not available at the time of this report.

To view the Marketplace enrollment snapshot report, please visit: https://www.cms.gov/newsroom/fact-sheets/marketplace-2024-open-enrollment-period-report-final-national-snapshot

Find out more via key highlights and improvements and infographic for the Marketplace 2024 Open Enrollment Period. For more information about how to enroll in Marketplace coverage, visit HealthCare.gov, CuidadoDeSalud.gov or your State-based Marketplace.

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