Obamacare health insurance signups hit record numbers in 2023 : Shots - Health News More than 19 million people have already signed up for health insurance through the marketplaces created by the Affordable Care Act. And you can still enroll through Jan. 16.

For the third year in a row, ACA health insurance plans see record signups

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MARY LOUISE KELLY, HOST:

It is the most wonderful time of the year if you are shopping for health insurance. It is open enrollment for Affordable Care Act plans for 2024. We, in fact, just passed a key deadline for coverage starting January 1. And for a third straight year, we're approaching a new record number of people who buy insurance through healthcare.gov - that is the marketplace set up by the Affordable Care Act - already well over 19 million people and still rising since the marketplace is still open for insurance that starts in February. Well, Health and Human Services Secretary Xavier Becerra is here to talk with us about it. Secretary Becerra, welcome back.

XAVIER BECERRA: Mary Louise, great to be with you.

KELLY: Why this increase?

BECERRA: I think people are realizing this is the best deal in town. They're also seeing that this is a great gift to give yourself or your family for the holidays. What better than to have not just a good health insurance policy, but peace of mind that comes with it? So you can take your child to the doctor or let them stay in a hospital and not go bankrupt.

KELLY: And I'll note y'all have done all kinds of outreach, trying to get the word out there, trying to make it easier to enroll. Can you tell what is working?

BECERRA: That's right. We have, in many cases, quadrupled the number of navigators that help people sort of understand what the process is, what the plans look like and which one really suits them best, because sometimes people resist signing up because they're not sure they're getting what they need. In this case, the navigators have done a tremendous job of explaining the insurance plans and making sure people are selecting the right plans. By the way, it doesn't hurt that four out of five people who are shopping are ending up getting a plan on the marketplace website for $10 or less a month in premiums. You can't go see a movie for $10 or less. One movie? Here's one month of health care coverage for $10 or less.

KELLY: OK, so a couple of points to put to you. One, there are still - even with this jump in enrollment, there are still about 25 million people who do not have health insurance in the U.S. What are you doing to address that?

BECERRA: That's right. And that number, 25 million, is 25 million too high. But it used to be about double that before the Affordable Care Act was signed into law, and so we've had tremendous success. You're seeing that we have record numbers signing up, so we'll probably break a record again. The thing that we're missing, Mary Louise, is that there are some folks who are still a little too poor to qualify, to be able to afford the care, but too rich to qualify to get on the Medicaid program, which is our federal program for those who are low-income. And if we just had about 10 states that still haven't expanded their Medicaid, which they were eligible to do so under the Obamacare law, we would probably help reduce that 25 million figure substantially. But there are some states that still refuse to help their citizens get on health insurance coverage due to the Medicaid program.

KELLY: Yeah, yeah. And I wanted to ask about Medicaid. This is - as you mentioned, this is federal and state insurance for low-income people. And just by way of backdrop, Medicaid rolls had swollen during the pandemic, now states are disenrolling people again. Do you have a number on that, how many people who lost Medicaid that have been able to get on an ACA plan?

BECERRA: We haven't been able to sort those numbers yet because the open enrollment numbers for the ACA, for the marketplaces, are just coming in. But it's clear that many people who had had Medicaid coverage are now on Obamacare coverage. So that's good news, that people are aware. We still believe that there are people who are falling through the cracks who don't have the information. By the way, we still believe that there are people who are losing their Medicaid in states that still qualify for Medicaid, and we're trying to work closely with states on that.

KELLY: What's the single biggest obstacle, Secretary Becerra, to getting every American health insurance? We said there's 25 million without health insurance in this country. You said that's 25 million too many. Is it lack of information? Is it lack of funding to increase and extend the subsidies? What is it?

BECERRA: Well, disinformation certainly is playing much more of a role today, Mary Louise, than before. But I'd say to you, the biggest impediment we have to really getting everyone covered is the fact that we don't have a national system to provide health care to people, we have a nationwide system.

The Constitution didn't give the federal government the power to make sure everyone had health care. The Constitution left that to every state, so some states do it really well. California, my state, does it really well. Some states, like the 10 states that I mentioned, are unwilling to go the next step to make sure that their citizenry have access to affordable health care. If we didn't have a nationwide system, if we had a national system that let us really ensure everyone had coverage and no one fell through the cracks, that 25 million number would dramatically decrease.

KELLY: Oh. Before I let you go, one more question. I want to note I've interviewed you a number of times over the years. And I looked and the last time was two years ago. We spoke in December 2021 and the subject was the omicron variant, which was raging. You were telling everybody, please test, please vaccinate. I guess I'm so struck at finding myself interviewing you today and asking you about the pandemic as almost an afterthought. How are you thinking about it these days after all we've lived through?

BECERRA: Well, Mary Louise, first, please, it should not be an afterthought to anyone. It is still killing Americans every day. COVID is still with us. In fact, the numbers are increasing. Hospitalizations are dramatically increasing. So I hope that - if you're listening, please get vaccinated, especially if you're getting ready to celebrate with family. Do not be the person who infects your 90-year-old grandmother with COVID. My mom just turned 90. I'm vaccinated, my family's all vaccinated, my mom is vaccinated. She has not yet caught COVID. We want to make sure that we see many more years of celebrating Christmas with my mother. So when you get ready to hug and kiss your loved ones, please, make sure you're safe. And the best way to make sure of that is to get vaccinated.

KELLY: Xavier Becerra is the Health and Human Services secretary. I wish your mom happy birthday, you happy holidays. Thanks for talking with us.

BECERRA: Mary Louise, thank you very much.

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