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President Joe Biden in the Oval Office of the White House on Jan. 28, 2021.
President Joe Biden in the Oval Office of the White House on Jan. 28, 2021.Mandel Ngan / AFP via Getty Images file

Biden takes a victory lap as ACA enrollments reach record highs

The Affordable Care Act's record-breaking enrollment total is fresh evidence that the ACA is quietly having an excellent year.


Seven years ago, when consumers were first able to sign up for health care coverage through the Affordable Care Act, 8 million Americans enrolled. 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.

It's against this backdrop that President Joe Biden took a victory lap this morning, boasting about the ACA's record-breaking enrollment totals.

"From November 1st to December 15th alone, more than 13.6 million Americans signed up for coverage through and the state-based marketplaces — an all-time high. That includes 1.8 million new enrollees, a significant accomplishment that builds on the success of our earlier Special Enrollment Period."

That special enrollment period was an underappreciated policy. As we discussed several months ago, it was just one week after his inauguration when Biden did what his predecessor would not: He issued an executive order creating a new enrollment period, citing a need created by the pandemic. Donald Trump was expected to do something similar last year, but the Republican refused because he didn't want people turning to "Obamacare" for help during a crisis.

Biden's policy worked, and nearly 3 million consumers took advantage of the special six-month period. When we add that total to the new consumers who've signed up for coverage during the regular enrollment period, 4.6 million Americans have gained health insurance this year who were previously uninsured.

What's more, these totals will almost certainly grow: The current enrollment period doesn't end until Jan. 15, and many consumers have a habit of waiting until the last minute.

Stepping back, it seems more than fair to say the ACA is having a very good year. Not only did the U.S. Supreme Court shield the ACA from its latest Republican attack in June, but the open enrollment data coincides with expansive new benefits included in the Democrats' American Rescue Plan. Some have seen their premiums cut in half, while many have seen their premiums fall to nearly or literally zero, thanks entirely to the investments in the Democrats' Covid relief package.

Indeed, the impressive enrollment tallies are not accidental. 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 insurance has never been more affordable than it is now.

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 the legislation will survive.

Watch this space.