“Enrollment has nearly doubled since I took office,” President Joe Biden said in a written statement. “That's not a coincidence,” he said, noting the administration's focus on making enrollment easier and more affordable. This includes extending enrollment periods, increasing funding for assistance and support, and increasing subsidies to lower premiums.
The news also marks the success of Georgia's new computer system for ACA shoppers, which launched on Nov. 1. Georgians are currently blocked from shopping on the federal ACA website healthcare.gov and must purchase ACA plans at GeorgiaAccess.gov.
A spokeswoman for Georgia Insurance Commissioner John King (R) declined to comment.
But White House officials said there was a need for caution going forward. The surge in popularity of ACA plans, which use federal subsidies to lower premiums for consumers, is due in large part to additional federal subsidies enacted during the pandemic. These “enhanced” subsidies are set to expire unless Congress decides to extend them.
“Wow,” said Sabrina Corlett, co-director of the Center on Health Insurance Reform at Georgetown University's McCourt School of Public Policy, when asked about Georgia's increase.
When states launch state-based marketplaces, called Georgia Access, they often see a drop in enrollment, she said.
“It’s actually quite impressive that we’re still seeing enrollment growth in Georgia, even with just the hassle factor (for customers) of switching to a new state-based platform. ” she said. “Designing, building, and launching a state-based exchange is no small feat.”
There were initial issues with the state-based website, but most were quickly addressed, a spokesperson said at the time. Whether a Georgia shopper purchases a plan directly on the website or through a private broker, the state website ultimately holds their information and is involved in the purchase. .
Corlett said Georgia's increased investment in Georgia Access advertising and support for navigators may also have helped encourage shopper participation.
But like other researchers, she said the main factor driving the popularity was the temporary premium subsidies enacted under the Biden administration, which are about to expire.
The ACA has always subsidized premiums based on shoppers' income levels. But “enhanced” subsidies were added to existing schemes to do more of that. They have reduced premium prices for both low-income ACA shoppers and middle-income shoppers.
For example, under the original ACA, subsidies were completely eliminated for people earning more than 400% of the federal poverty level, or about $60,000 a year. However, with the expansion of subsidies, it is now possible to receive subsidies even if insurance premiums exceed 8.5% of income. For low-income groups, the virtually free plan has been a game-changer.
“Congress faces a choice this year: If we do not extend the enhanced insurance premium tax credit passed in the Inflation Control Act, costs for millions of Americans will increase in real terms. ” White House adviser Neera Tanden told reporters. “The consequences would be devastating. A single parent could see their premiums increase by $1,500 a year. A retired couple could see their premiums increase by $18,000 a year.”
The extension of enhanced subsidies would cost about $335 billion over 10 years, according to the Congressional Budget Office.
King, whose office runs Georgia Access, and its founder, Gov. Brian Kemp, have argued that Georgia Access deserves credit for the large increase in Georgians enrolling in ACA plans in recent years.
