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Subsidies, White House push lead to surge in Obamacare registrations


Sheryl Hagen was earning $ 13.25 an hour after working more than five years in a Missouri grocery store. But even working full time, she couldn’t afford the $ 300 premium for her employer’s health insurance plan – so she did without.

Earlier this year, Hagen, 51, broke his rib and the resulting hospital stay led to a bill of $ 1,300. She didn’t have enough to pay for it, and taking the time to recuperate only set her back even further.

“I couldn’t move and not work and really couldn’t do anything,” she says. “And then I knew I was going to have these giant bills coming on me. It was terrifying.

This experience, an arthritic knee and a doctor’s visit later, led her to consider the special enrollment period for health care coverage under the Affordable Care Act, or Obamacare. With help, she was able to sign up for a market plan for $ 73 per month. When President Joe Biden then signed the US bailout, which provides huge healthcare subsidies for the next two years, she reapplied and her premium was reduced to $ 0.

“It’s like a light at the end of the tunnel,” said Hagen, who hasn’t had health insurance for 12 years. “I am blown away.”

Hagen is one of more than one million people who have signed up for Obamacare plans since the Biden administration opened the special registration period, which began on February 15 and ends on August 15. With the new subsidies and the limits of the Covid-19 relief bill placed on healthcare costs, many are also paying far less for Obamacare plans than they have in the past.

President Joe Biden signs the US bailout on March 11, 2021 in the Oval Office of the White House.Mandel Ngan / AFP – Getty Images

NBC News spoke to 16 people, eight of whom have signed up for Obamacare coverage or changed their plan since April 1 for more savings, as well as lawyers, doctors, insurance brokers and government officials at about recent changes to historic health care regulation.

Those who signed up, especially seniors who were not yet eligible for Medicare, said they felt Obamacare was finally living up to their expectations.

Jodi Smith, 62, has paid $ 400 to $ 600 in monthly premiums for her Obamacare plans since retiring from a county government job in Tucson, Ariz. About 10 years ago. With the new grants, she now pays $ 175 per month, which she says freed up her family income and that of her husband.

“That’s sort of what I envisioned the ACA when it was designed,” she said. “The first few years, it ended up being more expensive. We eventually evolved to a point where it works a lot better than it used to be. “

The new grants give tax credits to more registrants and help cope with the sudden soaring costs that some have suffered when their annual income fluctuates.

Experts and advocates have said the uncertainty of the pandemic, in which many have been made redundant and lost their employee-provided health insurance and the resulting need for affordable health care, has driven people to subscribe. But the main reason more than a million people signed up, they said, is likely due to the promise of additional savings.

“The reality is that the Affordable Care Act has excluded too many people from coverage,” said Emily Stewart, executive director of Community Catalyst, a left-wing consumer health advocacy group. “And so when Congress and the Biden administration adopted this policy to address it, I think that’s the main driver behind this wave that you see.”

The number of those who signed up for coverage could also be over 1 million, as the latest figures from the Department of Health and Human Services only cover the 36 states that use Healthcare.gov, the federal website. This ignores those who register in the 14 states and Washington, DC, who oversee their own markets – they are also able to take advantage of the new grants and many have opened their own special registration period in response. to the pandemic.

“These 36 states have had, for the most part, four years of drought, neglect and active efforts to, essentially, discourage enrollments,” said Peter V. Lee, executive director of the Health Benefits Exchange. from California. “And now we had a Biden administration that did some marketing, spread the word and said, ‘If people aren’t insured, they should know they have options.’ They also added what I would call fertilizers, which is the new American Rescue Plan grants.

The Biden administration has invested $ 100 million in marketing the Affordable Care Act and $ 80 million in nonprofit shipping programs that help individuals purchase health care coverage. Much of this funding was cut under President Donald Trump.

Lee said California has seen an increase in enrollments as well, although this is not as large as the federal peak because the state consistently invests high levels of funding in marketing and shipping programs.

But Lee noted that the grants have been a huge boon in helping low-income workers who don’t qualify for Medicaid afford health care coverage. It has also helped others by capping the amount people pay at 8.5% of their income.

“It really is a radical change,” he said.

The White House agrees, although it faces considerable work to make these subsidies permanent. As is, they expire within two years.

Christen Linke Young, deputy director of the White House Home Policy Council for Health and Veterans Affairs, said the Biden administration remains committed to ensuring the grants become permanent.

“The American Rescue Plan grants are a significant victory for American families,” she said. “The President has made it clear that he wants this to continue, and we look forward to working with Congress to make it happen.”

They have more political capital to work with these days.

Views on the Affordable Care Act have changed dramatically since the law was passed and implemented. At the height of its unpopularity, according to a Kaiser Family Foundation tracking poll, 53% of people viewed Obamacare negatively and 37% had a favorable opinion. That number has all but rocked with 54 percent now in favor of the health care law and 39 percent against it.

“You don’t have to like President Biden or like President Obama or like Obamacare to find it worthwhile to buy an affordable health insurance product,” Young said.

Overcome skepticism

Many said they were shocked at how much they were saving after re-enrolling in their Obamacare plan.

April Henry, an Oregon-based mystery writer who previously worked in the healthcare industry, said she and her husband were saving $ 700 a month on their bonuses after they re-enrolled after April 1. for retirement and to help their 25 year old daughter with upcoming dental surgery.

“It’s huge. It’s so much money,” she said. “I was really shocked at how great this was going to be.”

In reaching more people, however, Obamacare still has a difficult history to overcome: many still remember that it is overpriced and limiting.

“One of the big issues with the ACA was that people who earned over 400% of the federal poverty line would immediately lose their tax credit,” said Carolyn McClanahan, physician and financial planner in Jacksonville, Florida. “People owed thousands and thousands of dollars, and that gave ACA a really bad reputation. But now the tax credits are being phased out instead of suddenly disappearing. “

Pedro Rojas holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare, before the February 15 deadline, February 5, 2015 to Miami, Florida.Joe Raedle / Getty Images, file

Kenneth Smith, 62, lives outside of Pittsburgh and works in construction and sometimes as a truck driver. He said he decided to sign up for the Affordable Hospital Care Act when he was rushed there for diabetic shock this year.

Smith is still waiting for those hospital bills, but he admitted he had long had a skeptical view of the coverage Obamacare provides.

“From what I heard, it was garbage, it was unaffordable, and you got thrown down your throat – you had to take it or you paid a fine,” he said.

Before being hospitalized, Smith said he maxed out his credit card on a short-term “junk insurance plan” that didn’t cover any of his hospital bills. After his hospitalization, thanks to the grants, he said he was able to get a plan he could afford and cost half the cost of that offered by his employer.

“The insurance is fantastic,” he said. “The two medications I’m taking were 100% covered.”

I certainly had a few comments on the fact, “Well, in two years it’s going to go up right away.”

While many seem to be taking advantage of Obamacare’s new affordability, the White House still faces many questions and challenges. The main one is the current grant expiration date.

“The most important thing to remember is that these new affordability policies are temporary,” said Stewart. “They are only in place for two years. It is really essential that they be made permanent. “

The White House intends to do just that and has tied the grants to the President’s proposed U.S. Plan for Families, a $ 1.8 trillion investment in education, child care and family leave. paid. But with a slim majority in Congress, the Biden administration will face a challenge to get this package, along with a massive infrastructure bill, through either house.

There is also a sense of a boost over health care for some – particularly between the Republican and Democratic administrations.

Jenny Chumbley Hogue, who runs an insurance agency north of Dallas, said she had hired a number of people, some of whom had never been covered before. She said many are deeply conservative and critical of Obamacare.

“There are a lot of people, in general, who don’t believe it’s going to exist,” Hogue said. “I really had a few comments on the fact, ‘Well, in two years it’s going to go up right away.'”



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