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4 in 10 New Consumers Spend $10 or Less/Month on HealthCare.Gov Coverage

The Centers for Medicare & Medicaid Services (CMS) recently released a new report that shows that more than 1 million new and returning consumers have health coverage through the Health Insurance Marketplace that costs $10 or less per month after advance payments of premium tax credits (APTC) following the April 1 implementation of the American Rescue Plan’s (ARP) expanded APTC.

Of the 1,034,624 consumers who selected a Marketplace plan with premiums of $10 or less per month, after APTC, 687,275 were returning consumers and 347,349 were new consumers. This means 4 in 10 (43%) new consumers and 3 in 10 (30%) returning consumers and more than one third (34%) of all consumers have selected a plan of $10 or less per month following the implementation of ARP expanded APTC. The ARP’s expanded premium tax credits have reduced premiums, increased savings, and given consumers access to quality, affordable health care coverage through the Health Insurance Marketplace ®.

Over 1.2 million Americans signed up for health insurance since February 15 through HealthCare.gov as a result of the Biden-Harris Administration’s Special Enrollment Period (SEP) for the COVID-19 Public Health Emergency. These numbers reflect new enrollment above and beyond the record-high 31 million people covered under provisions of the ACA, as described in a recent HHS report – PDF.

“Having access to quality, affordable health coverage gives Americans peace of mind when they need to seek care,” said HHS Secretary Xavier Becerra. “Thanks to the Biden-Harris administration’s Special Enrollment Period and expanded premium tax credits from the American Rescue Plan, each week we continue to see more Americans experience the relief and security that comes with affordable, quality health coverage.”

For the first time, the SEP report includes comprehensive demographic data related to gender, race, and ethnicity for consumers who have signed up during this SEP. The newly included demographic data in the SEP report show that among enrollees who reported a race, 15% were Black compared to an average of about 11% in a similar window in prior years. Among those who reported ethnicity, 18% were Hispanic compared to an average of about 16% in prior years.

Additionally, 331,000 people who submitted an application through HealthCare.gov were assessed or determined eligible for enrollment in Medicaid or the Children’s Health Insurance Program (CHIP). People who need health coverage can apply for Medicaid and CHIP coverage year round through HealthCare.gov or by visiting their state Medicaid agency. CMS encourages all consumers who need health coverage to visit HealthCare.gov to see if they qualify for Marketplace, Medicaid or CHIP coverage.

Under the ARP, most consumers are able to take advantage of reduced monthly premiums through increased premium tax credits. Nearly 2.3 million current enrollees have returned to the Marketplace and reduced their monthly premiums by over 40%, from on average $103 to $61, after APTC.

For consumers new to the Marketplace selecting plans through the SEP, the average monthly premium after APTC fell 26%, from $117 for those enrolling in February and March to $87 for those enrolling in April and May. The ARP also helped to lower out-of-pocket costs for new consumers by making plans with less cost-sharing more affordable after the ARP’s expanded premium tax credits. The median deductible for consumers new to the Marketplace since February 15 fell by 83%, from $450 prior to April 1 to $75 for consumers new to the Marketplace selecting a plan from April 1 through May 31.

Now through Aug. 15, 2021, consumers who want to enroll in coverage, compare plan offerings, or learn if they qualify for more affordable premiums can check their coverage options by visiting HealthCare.gov or CuidadoDeSalud.gov. Consumers can view 2021 plans and prices and submit an application to see if they are eligible for enrollment and financial assistance. If eligible, they can enroll in a plan that best meets their needs. Current enrollees should review their application, make any changes needed to their current information, submit their application, and then select a new plan, or reselect their current plan, to receive the increased savings under the ARP.

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