Despite a recent warning from former President Donald J. Trump, the front-runner in the race for the 2024 Republican presidential nomination, that he was “seriously studying alternatives” to the Affordable Care Act, the latest emergence in registration on the market is a testimony to this. to the lasting power of the law.

Legislation passed earlier during the Covid-19 pandemic increased federal subsidies for people purchasing plans, reducing costs for many Americans. The Biden administration also lengthened the sign-up period and increased advertising for the program as well as funding for so-called navigators who help people sign up.

“More and more people are realizing they can access the market,” said Cynthia Cox, director of the Affordable Care Act program at KFF, a nonprofit health policy research group.

She added: “Just because the ACA has been around for a while doesn’t mean the people who need to sign up for it know how to do it. »

On Dec. 15 — the deadline to sign up for coverage that begins Jan. 1 — nearly 750,000 people opted into a marketplace plan on HealthCare.gov. This is the largest single-day total to date.

Dr. Benjamin Sommers, a Harvard health economist who served in the Biden administration, said improving awareness helped explain the record enrollments. “I’m pleasantly surprised,” he said.

With years of increasing subsidies, he added, “this may be the natural growth rate over a few years in a new policy environment.”

Kody Kinsley, North Carolina’s top health official, said his state has been creative in using its efforts to expand Medicaid to also enroll people in marketplace plans.

“We have done a very extensive education and outreach campaign – with civic organizations, churches, navigators – built around the expansion to educate people about eligibility,” he said in a text message.

He added, “As part of that, we help people get coverage through the marketplace, if they’re not eligible” for Medicaid.

The open enrollment period on Healthcare.gov runs through mid-January and ends on January 17 at 5 a.m. Eastern Time. People who sign up between now and then will receive coverage starting in February.

Biden administration officials said they encouraged enrollees who were already covered by HealthCare.gov to continue shopping for plans, in case a new option proves better and more affordable.

The Affordable Care Act marketplaces have become particularly valuable to people losing Medicaid coverage this year after a federal policy that guaranteed coverage earlier in the pandemic expired in April.

The millions of people dropping the Medicaid rolls has helped drive listings into the market, Ms. Cox said, and emerging during normally sleepier times outside of open listings. (Certain life eventssuch as the sudden loss of other health coverage, allow some Americans to obtain new plans outside of the open enrollment period.)

According to federal health officials, from March to September, enrollment in marketplace plans increased by 1.6 million people, 1.5 million more than during the same period last year.

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