ACA Enrollment Surges in 2024 as Affordability Improves and Medicaid Coverage Unwinds

2024 ACA Enrollment Reaches New Highs

Heralding great news on the healthcare front, a record 20 million Americans signed up for Affordable Care Act Marketplace coverage. This signifies a massive increase of 4 million compared to last year’s

record sign-up high

of roughly 16 million. How did factors like unwinding Medicaid and improved Marketplace subsidies contribute to record ACA Marketplace signups for 2024? Health insurance brokers from Sackett Insurance take a closer look. 

Understanding Medicaid Unwinding

In March 2020, as part of COVID-19 relief provided by the Families First Coronavirus Response Act, Congress gave states additional Medicaid funding. One condition of the extra resources was implementing a “continuous coverage” requirement. Under this provision, states couldn’t end most Medicaid beneficiaries’ coverage until after the public health emergency.

During the pandemic, states allowed continuous Medicaid enrollment, but that policy expired in April when disenrollments resumed. Sometimes, people were disenrolled because they didn’t qualify for the program, but others were disenrolled because they couldn’t complete the renewal process. The good news for those disenrolled because of procedural reasons is they may still qualify for coverage.

“Unwinding” is the term for states resuming yearly Medicaid eligibility reviews at the end of the continuous coverage requirement.

According to the Marketplace

, unwinding Medicaid is one of the major contributors to 2024’s record-high ACA enrollment.

Accessing More Affordable Coverage

Another factor helping Americans secure healthcare plans in 2024 is more affordable coverage. Greater ACA subsidies made private plans more accessible and eased the shift from Medicaid to private coverage for low-income people. Owed to a federal marketing budget and navigator and in-person assistance funding increase, more Americans learned about extra premium subsidies. Besides benefiting new enrollees, the improved subsidies also help those already enrolled in a plan keep their coverage.

At the end of 2025, ACA’s improved subsidies will no longer remain on the table. When that happens, Congress must decide whether to tap more federal funding to extend them.

Bolstering Individual Market Growth

Besides more affordable coverage and Medicaid unwinding, mid-year individual market growth outside the open enrollment window bolstered the ACA’s recent enrollment success. Between early April 2023 and the end of September that same year, enrollment in the individual market, which includes the ACA Marketplaces and off-exchange plans, increased by

roughly 6%

. Such a mid-year individual market enrollment increase is a rarity.

In the recent past, Americans shopped for healthcare plans at the Marketplace while between coverage. Whenever people would leave the Marketplace mid-year because they were priced out of plans or had other sources of healthcare coverage, the number of Americans exiting the market usually dwarfed the number entering the market. This is because the market doesn’t provide many chances for special enrollment. Even then, proving you qualify for mid-year signup can prove challenging. 

2021 was the only other time the market experienced mid-year growth, thanks to the American Rescue Plan Act’s greater subsidies and more chances for mid-year enrollment.

Navigating the ACA Marketplace

If you’re considering signing up for ACA Marketplace health coverage this year, tips from a health insurance broker can help you find an ideal plan:

  1. While exploring options, consider your current and future medical needs. For instance, do you or anyone in your family plan to undergo surgery or become pregnant? If you spent money on health insurance last year, do you expect that amount to change in the future? Knowing your most essential considerations helps narrow your plan options.

  2. Do you currently have a preferred clinic or doctor? If so, check if they are in-network in the available ACA Marketplace plans.

  3. For lower monthly health insurance premiums, consider a High-Deductible Health Plan. This kind of plan may benefit you if you’re in good health, don’t anticipate needing a medical procedure, and don’t expect any major upcoming medical costs. Make sure you always have money to cover your deductible and additional out-of-pocket costs.

Still need more help to find the best coverage? Sackett Insurance health insurance brokers are here to help!

Take the Pain Out of Health Insurance With Sackett & Associates Insurance Services

Although the ACA Marketplace saw record signups, finding the perfect

individual health insurance

plan can feel daunting. Sackett & Associates Insurance Services takes the pain and confusion out of the process to help you find the perfect coverage for you and your family. For over a decade, we’ve used our connections with major insurance providers to help California residents enjoy affordable, personalized health insurance.

For more information on PPOs, HMOs, Affordable Care Act subsidies, and more, contact one of our experienced independent health insurance brokers. Call (707) 823-3689 or

send us a message

to see how simple it is to enjoy peace of mind and better health with the right healthcare plan. 

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