AYESHA RASCOE, HOST:
Today in about 30 states, it's the last day to sign up for health insurance on healthcare.gov. And so far, it has been a banner year for ACA enrollment, otherwise known as Obamacare. About 16 million people signed up by the end of December, about a million more than a year ago. Julie Appleby covers health insurance markets for our partner, Kaiser Health News, and she joins us now. Good morning.
JULIE APPLEBY, BYLINE: Good morning.
RASCOE: So why have so many more people signed up this time? Like, what's different now than - compared to past years?
APPLEBY: Yeah, it's really interesting, right? We're seeing, you know, close to 16 million people, as you said, and that's up from, you know, 14 1/2 in 2022, which itself was a record. So this trend appears to be going up. And people who study this say there's several factors, but probably the biggest one is there are these enhanced subsidies that were first put into effect with the stimulus bill, and then they were extended in the Inflation Reduction Act, which was passed in August. And basically, these subsidies help people pay part or even, in some cases, all of their monthly premium.
So the new subsidies, folks are saying, might be one of the main reasons why people are signing up, because not only the amount's higher for a lot of people, but they've also eliminated this thing that was formerly called the subsidy cliff. So if you made a dollar more than the upper income amount, you wouldn't get any subsidy and your premium costs could go up a lot as a result. So they've eliminated that cliff. So basically, folks on the higher end of the income spectrum can qualify for a subsidy so long as their cost might be more than 8 1/2 percent of their income.
RASCOE: So, you know, when I was covering the White House and the Trump administration, there were these efforts to repeal Obamacare. When that didn't happen, the prior administration slashed some of the funding for it. So how has that changed?
APPLEBY: Yeah, that definitely was true. They substantially cut the funding for outreach and what are called these navigators or assisters. And these are people that help consumers enroll in coverage. The Biden administration has restored that funding, and they've also done a couple other things. They've increased the duration of the open enrollment period, which the Trump administration had shortened. So there's more money, and there's more time. And that could be another reason why people are signing up more.
RASCOE: So, you know, with more people enrolling and more people getting help - you know, that is more people who will have health care. But in this country, there's still a lot of people without health insurance, right?
APPLEBY: That is correct. I mean, there's, like, good news and bad news, right? They're - we're at the lowest rate ever last year at 8% of the population who are uninsured. But that's still 26 million people. And there's a variety of reasons that people remain uninsured. I mean, some people just don't want insurance, right? Some people can't afford it. It's expensive, especially if you don't get a subsidy. A lot of people's jobs don't offer it. And some people still don't know that these options are out there.
RASCOE: OK, so they have the rest of today to do it at healthcare.gov. But does the marketplace close up shop, you know, when the - until the next enrollment period? Is it just, you know, done?
APPLEBY: No, they don't entirely - no gone fishing sign in the window. No, they don't close up. They remain open, but only for certain folks. Look, if you have something that happens, what they - in the jargon is called a qualifying life event, like you lose your insurance for some reason. Maybe you lose your job. Maybe you get divorced. Maybe you get married. I mean, there's all kinds of reasons you might have a qualifying life event. Then you can sign up under a special enrollment period. And also new - it started late last year, but also new is for certain low-income folks, there is no only one annual period. It's every month they could sign up.
RASCOE: That's Julie Appleby of Kaiser Health News. Thank you so much for being here.
APPLEBY: Thanks for having me. Transcript provided by NPR, Copyright NPR.
