The U.S. Department of Health and Human Services just released a report asserting that 31 million people now have insurance coverage thanks to the Affordable Care Act. That would be a record, an increase of nearly 4 million from 2020.
That headline number could go up in the months to come. But the growth of Obamacare-linked coverage is largely a function of the federal government throwing billions of taxpayer dollars at Medicaid, private insurers, and even the wealthy.
The HHS report estimated that about 11.3 million people had enrolled in exchange coverage through February. At least 1 million more have signed up through a special enrollment period opened up by the Biden administration, first through May 15 and then extended through Aug. 15.
Biden has made exchange coverage much more attractive by increasing subsidies for it. The Democrats’ American Rescue Plan Act, passed into law in March, ratcheted down the share of income that everyone making less than 400% of the federal poverty level, or about $51,000 for an individual, has to put toward their premiums. For the first time, Biden began subsidizing coverage for people who make more than four times the poverty level.
The Congressional Budget Office estimates that these new subsidies will cost more than $34 billion, with most of that bill hitting next year. About 1.3 million people who were previously uninsured will gain coverage. That’s a tab of more than $16,800 per newly insured person. About 60% of the 31 million patients with coverage thanks to the Affordable Care Act are in Medicaid. And about 4 million of those new Medicaid enrollees were eligible for the program prior to the passage of Obamacare.
All these people with exchange or Medicaid coverage may not have easy access to care. Nearly three-quarters of exchange plans have narrow provider networks, so patients may not be able to visit their preferred doctors and hospitals. About 3 in 10 doctors don’t accept new Medicaid patients.
Given how much money the Biden administration is spending on Obamacare, it would be notable if the president were not setting enrollment records.
Sally C. Pipes (@sallypipes) is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020).