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The Biden administration says a record 24 million people have enrolled in health plans from Affordable Care Act marketplaces. NPR's Selena Simmons-Duffin reports that could change when President-elect Trump takes office.
SELENA SIMMONS-DUFFIN, BYLINE: If you've heard this before, record enrollment in healthcare.gov and the state marketplaces, that's because there was just a record set last year and the year before.
CYNTHIA COX: This year, I was actually expecting the enrollment growth to maybe plateau a bit.
SIMMONS-DUFFIN: That's Cynthia Cox of KFF, a non-partisan health research organization. She says the past few years, there were clear reasons for those record numbers, like lower premiums and higher demand because of the COVID pandemic. Nothing big changed this year that would keep pumping up demand.
COX: So I think it's really remarkable that it's continuing to reach new, record highs.
SIMMONS-DUFFIN: This year's record, 24 million people, is a lot. When President Biden took office four years ago, it was only 12 million, and that increase has chipped away at the overall number of uninsured people in the U.S. Xavier Becerra, Secretary of Health and Human Services, briefed reporters earlier this week.
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XAVIER BECERRA: Today, more than 300 million Americans have health coverage. That's a record number.
SIMMONS-DUFFIN: White House domestic policy adviser Neera Tanden told reporters on the call these numbers show that Biden administration policies have worked.
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NEERA TANDEN: We made the largest investment ever into outreach efforts that help people sign up for health insurance. We've also eliminated bureaucratic red tape and, crucially, we've lowered health insurance premiums.
SIMMONS-DUFFIN: Now the question is, will any of this last after President Trump takes office? Trump has kept open the possibility of repealing the 14-year-old Affordable Care Act. He said in the presidential debate that he had the concepts of a plan for replacing it. Republicans who are set to take the majority in both houses of Congress, by and large, oppose the ACA. They especially don't like the enhanced federal subsidies from the pandemic era. Many people can now get plans for $10 a month. Those subsidies will expire next December unless Congress extends them. Again, here's Cynthia Cox from KFF.
COX: If I was placing a bet, I would feel much more comfortable betting that the enhanced subsidies will be allowed to expire at the end of this year.
SIMMONS-DUFFIN: Neither the Trump-Vance transition team nor House Speaker Mike Johnson's office responded to NPR's request for comment. Cox says the only way the ACA boom could continue is if a few Republicans joined Democrats in voting to extend the subsidies, and that might happen because...
COX: Where you have seen the most growth in ACA signups, and also where people are benefiting the most financially, actually tends to be in red states.
SIMMONS-DUFFIN: The biggest growth has been in Texas. In the last four years, enrollment there has gone up more than 200%.
Selena Simmons-Duffin, NPR News, Washington. Transcript provided by NPR, Copyright NPR.
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