Total plan selections represent a 17% increase over last year, and includes a significant increase in new enrollees on Healthcare.gov

With four out of five people eligible for coverage at $10 or less, the Biden-Harris Administration urges everyone to visit HealthCare.gov and sign up for high-quality, affordable health care

ACA Marketplace National Enrollment Snapshot

The Biden-Harris Administration announces nearly 3.4 million people nationwide have selected an Affordable Care Act (ACA) Marketplace health plan since the start of the 2023 Marketplace Open Enrollment Period (OEP) on November 1. This represents activity through November 19 (Week 3) for the 33 states using HealthCare.gov and through November 12 (Week 2) for 16 states and the District of Columbia with State-based Marketplaces (SBMs).[1] Total plan selections include 655,000 people (19% of total) who are new to the Marketplaces for 2023, and 2.7 million people (81% of total) who have active 2022 coverage and returned to their respective Marketplaces to renew or select a new plan for 2023. These plan selection numbers represent a 17% increase in total plan selections over last year.

As President Joe Biden and Secretary Xavier Becerra announced, new customers enrolling on Healthcare.gov are up nearly 40% over last year. On November 16, Healthcare.gov had 493,216 new enrollees, compared to 354,137 on the same date in last year.

The 2023 Marketplace OEP runs from November 1, 2022 to January 15, 2023 for states using the HealthCare.gov platform. People generally need to submit an application and choose a plan by December 15 for their coverage to start January 1. State-based Marketplace enrollment deadlines vary. State-specific deadlines and other information are available in the State-based Marketplace Open Enrollment Fact Sheet.

“We are off to a strong start – and we will not rest until we can connect everyone possible to health care coverage this enrollment season,” said HHS Secretary Xavier Becerra. “The Biden-Harris Administration has taken historic action to expand access to health care, and ensure everyone can have the peace of mind that comes with being insured. With four out of five people eligible for coverage at $10 or less, do not miss your opportunity to sign up for high-quality, affordable health care. We urge everyone to visit HealthCare.gov and find the coverage that meets your needs.”

“Providing quality, affordable health care options remains a top priority. The numbers prove that our focus is in the right place. In the first weeks of Open Enrollment, we have seen an increase in plan selections and a significant increase in the number of new enrollees over the previous year,” said CMS Administrator Chiquita Brooks-LaSure. “I am pleased to see such a strong early showing and I encourage all those looking for affordable health care coverage to visit HealthCare.gov.”

The Biden-Harris Administration has made expanding access to health insurance and lowering health care costs for America’s families a top priority, and under their leadership, the national uninsured rate reached an all-time low earlier this year. 

The Biden-Harris Administration encourages all families to visit HealthCare.gov and check out the health care coverage options and savings available to them. This year, thanks to the Inflation Reduction Act, more people will continue to qualify for help purchasing quality health coverage with expanded financial assistance. Thirteen million Americans will continue to save an average of $800 per year on their health insurance. Four out of five people will be able to find a plan for $10 or less after tax credits. People with coverage through HealthCare.gov are encouraged to return and shop to see if another plan better meets their needs at a lower cost.

Individuals can enroll or re-enroll in health insurance coverage for 2023 by visiting HealthCare.gov, or CuidadoDeSalud.gov, or by calling 1-800-318-2596 to fill out an application. Individuals wanting assistance signing up for coverage may go to Find Local Help on HealthCare.gov to find a Navigator, Certified Application Counselor, or agent or broker: https://www.healthcare.gov/find-assistance/.

Marketplace Enrollment Snapshot Overview:

To view the first Marketplace enrollment snapshot report, please visit: https://www.cms.gov/newsroom/fact-sheets/marketplace-2023-open-enrollment-period-report-national-snapshot

Find out more via key highlights and improvements and infographic for the Marketplace 2023 Open Enrollment Period. For more information about how to enroll in Marketplace coverage, visit HealthCare.gov, CuidadoDeSalud.gov or your State-based Marketplace.

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California is on the cusp of becoming the first state to offer all residents health care coverage, regardless of their immigration status. But figuring out the best way to do that is the focus of current debate. 

“It’s an amazing threshold moment for us,” said Katie Heidorn, the executive director of the health policy nonprofit Insure the Uninsured Project. “It’s really no longer a question should everyone be covered, but how should we make it accessible and affordable to everyone and how do we pay for it?”

This year, California lawmakers who support the expansion will have a choice: add more people to the current public health system or overhaul it altogether with a single-payer option for everyone. Advocates say either represents a trail-blazing move, even though challenges in accessing care would remain.

The right moment, proponents say

While there have been multiple efforts to create universal health care in California in recent years, the political landscape might be finally ripe for the effort, said Heidorn, a longtime health policy observer. Gov. Gavin Newsom campaigned in support of single-payer health care, and the state fully embraced the Affordable Care Act, which significantly expanded coverage through Medicaid and the health exchanges. 

“We are close to universal coverage already, with the implementation of the ACA, recent coverage expansions in Medi-Cal, and subsidies made available to people purchasing coverage through Covered California,” Heidorn said. “The proposed expansions and subsidies outlined by the governor would close most of the remaining gap.”

California residents currently receive health care in a variety of ways. Nearly half of state residents have private insurance coverage from their employer, according to Kaiser Family Foundation 2019 data. About one-third of Californians rely on Medi-Cal, the state’s Medicaid program for low-income adults and children. Older adults receive coverage from Medicare, the federal government health plan for older adults, and some residents who earn too much to qualify for Medi-Cal purchase private insurance through the ACA’s marketplace plans, often using government subsidies to help with the cost.  

Since 2016, California has provided Medicaid benefits to all low-income children, regardless of their immigration status. More recently, the state expanded Medicaid in 2020 for low-income younger and older adults regardless of immigration status, leaving out adults age 26 to 49.

Closing the coverage gap

Newsom’s current budget proposal would use state funds to close that uninsured gap, extending Medicaid coverage to all qualifying residents regardless of immigration status, starting in January 2024. The budget also provides for enhanced subsidies for those who buy their health insurance on the exchange plans.

While Newsom had previously voiced support for a single-payer system, he’s stayed quiet on the current legislation put forward by state Assembly member Ash Kalra, D-San Jose, leading some observers to view this effort as his more practical alternative. It would fill the coverage gaps, without the hefty cost and logistical burden of starting anew.

“The governor’s proposal to expand Medi-Cal to the 26 to 49 group could be a direct alternative to what’s happening in the legislature,” said Paulette Cha, a research fellow at the Public Policy Institute of California, whose research focuses on the health of underserved populations. “It makes sense, this more incremental approach, which is less of an overhaul of the entire system.”

It would still be a significant coverage expansion, addressing a large population who may have gone long periods without accessing primary care, she said. The state estimates the measure would extend health care to about 764,000 undocumented immigrants.

“This is the big one – the big expansion,” Cha said. “This is most of the individuals we think of as still needing health care.”

This year, nearly 3.2 million Californians will still be uninsured, and undocumented residents make up the largest portion of that group, according to researchers at the UC Berkeley Labor Center and the UCLA Center for Health Policy Research. In 2022, two-thirds of undocumented Californians under the age of 65 will still be uninsured, they found, with even more seniors who weren’t included in the modeling.  

The budget proposal pegs the expansion at $2.7 billion annually once it’s fully implemented. The provision to further expand Medicaid is part of the state budget process, which means it a revised version will likely come in May, with the legislature voting on passage by mid-June. 

Single payer, with financing bill

Meanwhile, the state assembly is considering a single-payer option. Assembly Bill 1400, or CalCare, would overhaul California’s health care system altogether, cutting out all insurers —including Medicare and Medi-Cal — and creating one public plan for everyone. Along with the logistical hurdles of creating a new system, there is a big funding question.

While previous single payer efforts haven’t addressed the financial details, this latest effort has a companion funding bill. Assembly Constitutional Amendment 11, lays out the effort’s funding strategy, which would come through a variety of taxes on individuals and businesses. It remains unclear exactly how much a single-payer system would cost, and the cost of such plans has proved a major stumbling block for similar efforts in the past.

“This is the big one — the big expansion. This is most of the individuals we think of as still needing health care.” 

                                                              — Paulette Cha, Public Policy Institute of California

“Running a companion tax bill lets the Legislature have that conversation: What does it cost and who pays for it?” Heidorn said.

There are other big questions, too, observers say. For example, what would happen to the money the federal government pays for Medicare and its shared cost of Medi-Cal? Would the government agree to send those funds to California, or would the state be on its own? And will a significant lobbying effort led by powerful insurance companies, medical groups and hospitals block the effort?

AB 1400 requires a simple majority approval vote in the Assembly by Jan. 31 before moving on to the Senate. The governor has the power to veto this legislation. The companion funding component (ACA 11) would require a two-thirds vote in both chambers before going before voters on the ballot.

Coverage doesn’t equal access

The legislative strides are also set amid a backdrop of other health care reform efforts such as the Healthy California for All Commission, a group tasked with creating recommendations to improve health care delivery, financing and access.

While both legislative approaches represent groundbreaking leaps in advancing coverage, access challenges will likely persist, observers say. Even if more people had health insurance on paper, they may still struggle to get care in areas like the Central Valley that face chronic provider and specialist shortages.

Under Newsom’s proposal to expand Medi-Cal regardless of immigration status, some undocumented immigrants might still refuse coverage, fearful those benefits could negatively impact future citizenship efforts. Unhoused people and farm workers who move around the state might also struggle to get care.

Still, there is reason for optimism in increasing coverage. Either of the current choices would represent a significant step forward for the state and have an outsized impact on some of the state’s most vulnerable residents. It’s even more striking when you consider the ACA’s landmark coverage expansion didn’t roll out until 2014.

“If California does this, it would be enormous,” Heidorn said. “It’s an exciting moment that could change the lives of many people.”  

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“We’re continuing to answer the clear call from the American public for affordable, accessible care,” said Health and Human Services Secretary Xavier Becerra. “The Biden-Harris Administration has already made historic investments to help connect communities to coverage. By continuing to build a policy framework that can support this momentum, we’re also building back better for communities in need.”

“Health care is a basic human right, and the Biden-Harris Administration is committed to making health coverage more accessible than ever. With the Affordable Care Act and the American Rescue Plan, the President has brought affordable health coverage to millions—many of whom now have insurance for the first time,” said CMS Administrator Chiquita Brooks-LaSure. “Today’s action to extend the Open Enrollment Period by a month, to continue our investment in local health care Navigators, and to establish a special enrollment period for many low-income people further demonstrates our commitment to connect families to coverage.”

Today’s final rule on the 2022 Payment Notice expands Navigator services to help reduce health disparities. Navigators in FFMs will now provide consumers with information and assistance on certain post-enrollment topics, such as the Marketplace-eligibility appeals process and Marketplace-related components of premium tax credit reconciliation. CMS will support more outreach and engagement through modest increases to Marketplace issuer user fee rates. All 2022 Marketplace user fee rates remain lower than those for 2021, which should help keep premiums low. Additionally, four times as many Navigators—1,500 in all—will be available for consumers who use HealthCare.gov for the 2022 plan year thanks to $80 million in grant funding provided earlier this year by CMS.

To enhance these efforts, CMS will connect this work to the Champions for Coverage program, a community initiative to spread the word about Open Enrollment with educational resources and “event-in-a-box” materials. Organizations can learn more about becoming Champions for Coverage by visiting: https://marketplace.cms.gov/technical-assistance-resources/assister-programs/champion.

“We invite national and local organizations representing uninsured communities to join the Biden-Harris Administration as we work to share the peace of mind that comes with health coverage,” observed Administrator Brooks-LaSure. “Champions for Coverage know their communities best. CMS is committed to listening to and working with our community partners as we embark on our most robust outreach and engagement campaign in the agency’s history.”

In addition to extending the Open Enrollment Period and supporting the work of Navigators, CMS established a new monthly special enrollment period targeting certain low-income individuals in Marketplaces through HealthCare.gov. This opportunity provides the vast majority of eligible consumers with one or more options to enroll in free or very low-cost plans thanks to provisions in the American Rescue Plan.

The provisions CMS announced today also include important flexibilities for state partners. For example, state Marketplaces with their own eligibility and enrollment platforms will be able to set their own annual Open Enrollment Period end dates, so long as these dates are on or after December 15, 2021. More details on these and other components of the 2022 Payment Notice can be found in the fact sheet available here: https://www.cms.gov/newsroom/fact-sheets/patient-protection-and-affordable-care-act-updating-payment-parameters-section-1332-waiver. 

Today’s “Patient Protection and Affordable Care Act; Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond” final rule completes the rulemaking process for the 2022 Payment Notice, which included parts 1 and 2 issued on January 19 and May 5, 2021, respectively. To view the rule released today, please visit: https://www.cms.gov/files/document/cms-9906-f-nbpp-webposting-version.pdf

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