“If enhanced subsidies are not renewed by Congress and are instead allowed to expire at the end of 2025, ACA enrollee premium payments are expected to increase by over 75% on average……………”
(THIS DOESN’T MEAN PREMIUMS WILL INCREASE PER SE, ONLY THE ENROLLEE’S COST WILL INCREASE IF THE SUBSIDY (WELFARE) PAYMENT ENDS)
A Look at ACA Coverage through the Marketplaces and Medicaid Expansion Ahead of Potential Policy Changes
Jennifer Tolbert, Clea Bell, Cynthia Cox, Jared Ortaliza, and Robin Rudowitz
Published: Jan 15, 2025
The Affordable Care Act (ACA) expanded health insurance coverage by extending Medicaid coverage to nearly all adults with incomes up to 138% of the federal poverty level (FPL) ($20,783 for a single individual in 2024) and by creating new health insurance Marketplaces through which individuals can purchase private insurance coverage with financial help to afford premiums and cost-sharing. Marketplace subsidies are available for individuals not eligible for Medicaid with incomes above 100% FPL. The Medicaid expansion was originally mandatory for states, but expansion became effectively optional after a Supreme Court decision in 2012. States can opt to provide more affordable coverage to individuals who would otherwise be eligible for Marketplace coverage with incomes between 133% and 200% FPL through a Basic Health Program (BHP). In 2024 Minnesota had a BHP plan, Oregon newly implemented a BHP on July 1, 2024, and New York had a BHP until April 2024 when it transitioned to provide the same coverage to individuals with incomes up to 250% FPL through the state’s Essential Plan (EP).
In total, 2024 ACA enrollment (including Marketplace, Medicaid expansion, and BHP) reached 44 million, or 16.4% of the nonelderly U.S. population. In 2024, Marketplace enrollment hit a new record high, of 21.4 million people (almost double the 11 million people enrolled in 2020), Medicaid expansion enrollment was 21.3 million (a 41% increase from 2020), and BHP enrollment in 2024 was 1.3 million (up from 880,000 in 2020)
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