Millions of Americans can start choosing health insurance plans for 2023 on today, as the Biden administration pushes to keep the number of uninsured Americans at a record low.

Those looking for coverage will be largely protected from increased costs due to the extension of subsidies that began last year as part of the Democrats’ $1.9 trillion coronavirus relief bill that has dramatically increased enrollment.

The breaks will keep your monthly premium payments at $0 or a few dollars per month for most people who enroll.

“More and more people are beginning to realize that they can get coverage that they can afford,” Health and Human Services Secretary Xavier Becerra said Monday.

About 14.5 million people get health insurance coverage through the Affordable Care Act, an Obama-era law that marked a decade in business.

Most people – 92% – seeking coverage in the market will have at least three insurance companies to choose from when choosing plans.

But access to health care remains difficult in some areas. At least nine states have one or more counties where only one insurance company sells its plans in the ACA market for the next year.

The extension of the most generous subsidies, until 2025, “helped avoid a situation where there would be an adhesive shock from the large increases expected,” said Massie Worley, director of health consultancy Avalieri. “We are in an affordable environment. We are again looking for very high enrollment rates.”

Private plans on the market that may previously have been out of reach for many families are suddenly becoming free with larger subsidies. For example, a family of four with an annual income of $69,375 has seen its average premium drop from $75 last year to $0 this year, according to data released last week by the Centers for Medicare and Medicaid Healthcare. The premiums for registrants are a maximum of 8.5% of their income.

Only 8% of Americans were without health insurance as of August, the lowest level ever, according to the Department of Health and Human Services.

There has been a significant increase in ACA enrollment this year among blacks and Latinos, according to new HHS data. Between 2020 and 2022, Latino enrollments jumped from 1.7 million to 2.6 million while 1.3 million blacks enrolled last year, up from 900,000 the year before.

The registration increase comes as the Biden administration has boosted spending on navigators who work in communities across the country to help people sign up for coverage. The administration poured hundreds of millions of dollars into the effort after the Trump administration, which had sought a legal end to the Affordable Care Act, scaled back the program.

In Richmond, Virginia, navigators have already booked appointments for the next two weeks with people willing to meet to discuss health care options for next year, said Sarah Cariano, chief health insurance navigator at the Virginia Poverty Law Center.

“The plans and options change every year, it’s really important to go in and make sure you’re still enrolled in the plan that’s best for you and your family,” she said.

In Delaware, for example, residents will have more than one health insurance company to choose from during the first-time open enrollment period.

Healthcare experts don’t expect significant gains in enrollment during this year’s enrollment period, which runs through January 15. Entrants must sign up by December 15 in order to receive coverage immediately starting in the new year.

“We’re really at peak enrollment,” said Cynthia Cox, director of the ACA program at the Kaiser Family Foundation. “It’s hard to predict how many people might come.”

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