WASHINGTON (AP) — A record 24 million people have signed up for coverage through the Affordable Care Act, former President Barack Obama’s landmark health law, as the program faces an uncertain future under a Republican-controlled White House and Congress .
Never before have so many people signed up for health insurance through the government marketplace, a point of pride for many Democrats but a warning sign for some Republicans.
President Joe Biden has pushed an expansion of the program, signing into law billions of dollars in tax credits that have expanded eligibility for health insurance and reduced its cost. Millions of additional Americans can now pay monthly premiums of just a few dollars to get coverage.
The increased enrollment is “not a coincidence,” Biden said in a statement. “When I took office, I promised the American people that I would lower the cost of health care and prescription drugs, make it easier to enroll in health insurance, and strengthen the Affordable Care Act, Medicare and Medicaid.”
But the novel President Donald Trump has been denigrating “Obamacare” for years. He tried unsuccessfully to dismantle it during his first term and promised changes in his second term – without offering a concrete plan. Enrollment fell during Trump’s first term as his administration invested less money in the program, including for navigators who lend a hand people sign up for coverage.
And the tax credits that have made health insurance more affordable for millions are set to expire at the end of this year unless Congress passes novel law.
Lawmakers will face a pressure campaign from hospitals and insurance companies that offer marketplace coverage plans to continue the tax credits. A newly formed coalition of the largest and most powerful health care organizations — including the nation’s leading health insurers, largest health systems and prominent physician groups — has launched a campaign called “Keep Americans Covered” to lobby Congress on the issue.
Still, it’s an uphill battle with Republicans, some of whom initially voted against the Affordable Care Act and others who voted to repeal it years later. Still, some might pause at the thought of effectively stripping their constituents of health insurance coverage.
Republican Sen. Lisa Murkowski told the Alaska Beacon last week in an interview about rising health care costs that Congress “needs to continue these premium tax credits.”
But other Republicans have raised questions about the tax credits, particularly given continued enrollment growth. Last year, a group of GOP officials called for an investigation into Affordable Care Act enrollment, citing concerns that people were defrauding taxpayers by reporting wrong income levels to qualify for cheaper health insurance.
In a call with reporters on Tuesday, Biden administration officials rejected that, saying automated systems verify a person’s income based on previous year’s tax returns.
Trump, in turn, described the Affordable Care Act as “costly” and described the health care it provided as “lousy.”
But he still hasn’t presented a full plan for how to improve it.
“We have concepts of a plan that would be better,” he said during an interview on NBC’s “Meet the Press” last month.
Open enrollment on HealthCare.gov ends January 15.
