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It's not an accident that ACA enrollments reached an all-time high

Celebrating the new ACA enrollment totals, President Joe Biden said, "This did not happen by accident." By any fair measure, he has a point.
Image: Obamacare Tax Subsidies Supreme Court
Protesters in support of the Affordable Care Act outside the Supreme Court on June 25, 2015.Andrew Harrer / Bloomberg via Getty Images file

Eight years ago, when consumers were first able to sign up for health care coverage through the Affordable Care Act, 8 million Americans enrolled. As we recently discussed, the Obama White House and health care advocates saw it as a victory, which it most certainly was, though many imagined even better numbers to come.

At the time, however, even optimistic observers might've been surprised by the latest enrollment data. HuffPost's Jonathan Cohn reported this morning:

Approximately 14.5 million people signed up for private coverage through or one of 18 state-run marketplaces during this year's open enrollment period, the Biden administration announced Thursday. That is the highest number ever.

In a written White House statement this morning, President Joe Biden celebrated the numbers and boasted, "This did not happen by accident."

He has a point. Circling back to our earlier coverage, more Americans signed up for coverage, in part because the Biden administration launched an initiative to get people signed up — complete with a renewal of the navigator program — and in part because officials extended the length of the enrollment period.

But perhaps most important of all is the fact that insurance has never been more affordable than it is now: Democrats included generous new ACA subsidies in the party's American Rescue Plan last year, with some consumers seeing their premiums fall to nearly or literally zero, thanks entirely to the investments in the Democrats' Covid relief package.

It caps a 12-month period that also saw the U.S. Supreme Court shield the ACA from its latest Republican attack, coinciding with Republicans quietly dropping ACA repeal from its to-do list. There's even some evidence that the uninsured rate is improving again, after inching higher under the previous administration.

There are, however, some clouds on the horizon. As regular readers know, the ACA-related benefits included in the American Rescue Plan are, at least for now, temporary. The White House and Democratic leaders want to make the current benefits permanent, and it's a central pillar of the Build Back Better package, but it's an open question as to whether Sen. Joe Manchin of West Virginia will allow the new status quo to continue.

Watch this space.

Postscript: While today's news is based on coverage data from the recently completed enrollment period, it's worth emphasizing that in five states — California, Kentucky, New Jersey, New York, and Rhode Island — as well as Washington, D.C., consumers can still sign up through Monday, Jan. 31.