- Enrollment in the Affordable Care Act federal exchanges during this year's open enrollment period reached 8.2 million, just shy of last year's total despite including fewer states as a result of them moving to their own exchanges, according to preliminary figures released Friday.
- CMS said that, adjusting for the removal of those states from the federal exchange, year-over-year plan selection for 2021 increased 6.6% from 2020, 6.3% from 2019 and 2.2% from 2018.
- About a quarter of the enrollees signed up for an ACA plan for the first time while the rest were returning customers or people who were automatically re-enrolled.
The Trump administration touted the figures despite ongoing efforts to hamstring the ACA, including supporting the case currently before the U.S. Supreme Court to overturn the decade-old law. Justices heard arguments last month and are expected to rule next spring or fall.
One month from now, however, support for the ACA in the federal government will look much different as President-elect Joe Biden and his team take the reins. Biden's nominee for HHS secretary, California Attorney General Xavier Becerra, has been a staunch supporter of the act and led the coalition to defend it before the high court.
CMS under Biden is also likely to take a different course on states attempting to decentralize ACA marketplace functions. The Trump administration in early November approved Georgia's waiver to do so, by ending its use of the federal Healthcare.gov marketplace site without instituting a state-based replacement.
Biden has also floated the idea of creating a special enrollment period as people continue to face job losses as a results of the COVID-19 recession. He has also proposed methods for increasing premium tax credits and subsidies for people in the exchanges.
Payers have been increasingly interested in participating in the ACA marketplace. For the third year in a row, more insurers entered the exchanges for the 2021 plan year, according to the Kaiser Family Foundation. Its analysis found that 30 payers joined across 20 states while more than 60 expanded their service lines in existing regions.
Currently, 32 states use the federal exchange, for which open enrollment runs from Nov. 1 to Dec. 15 and coverage begins Jan. 1. Most states with their own exchanges are continuing open enrollment for at least another week.