The federal Affordable Care Act exchanges on Thursday included new subsidies to help 15 million uninsured Americans purchase coverage.
The Biden administration approved the subsidies in March, under the American Rescue Plan, estimating that expanded premium assistance would result in four out of five customers purchasing a plan on the marketplaces with premiums of $10 or less per month. The Kaiser Family Foundation estimated the law increased the number of people eligible for a subsidy by 20%, to 21.8 million.
A federal report released in February estimated the increased subsidies—along with the extension of COBRA insurance—would cost the federal government more than $54 billion over the next decade and result in less than 2 million more people gaining health coverage.
"People deserve the peace of mind that comes from knowing you can take care of your health without going into debt," HHS Secretary Xavier Becerra said in a statement.
Individuals who previously purchased plans on the exchanges may qualify for the subsidies. Enrollees will need to return to the federal exchange to claim their premium savings, and can also switch plans. Enrollees who don't claim their subsidy will receive their premium discount as a larger tax credit on their next return.
About a third of uninsured Americans will qualify for financial assistance if they sign up, and Vox reported that nearly 7 million people will be eligible for plans where the government pays their monthly premium in full.
Americans who purchase their own insurance outside the ACA exchanges may also qualify for subsidies.
The Biden administration is showcasing this opportunity through an outreach campaign that includes TV and digital advertising, along with texting and emailing educational messages to enrollees. On Thursday, HHS committed another $50 million to the effort, bringing to total investment in the advertising initiative to $100 million.
Increased outreach and financial help for those purchasing health insurance serves as a direct contrast to the Trump administration, which refused to create a special enrollment period during the COVID-19 pandemic and, throughout its four-year term cut outreach funding for the exchanges. Officials said the special period would be unnecessary, as people could enroll due to changes in employment or other circumstances without the designation.
Despite the cuts, the number of insurance options for consumers on the exchanges has grown in recent years.
In 2021, the Kaiser Family Foundation reported that just 10% of counties had a single insurer offering, down from 25% the year before. Cigna recently announced plans to double its geographic coverage on the individual market by 20 states by 2025, and UnitedHealthcare and Aetna are also reentering the space. There is evidence that the ACA is now one of the most profitable lines of business for insurers, second only to the valuable Medicare Advantage market.