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Official 2021 Affordable Care Act Enrollment Reaches 12.0 Million QHPs For First Time Since 2016

Let’s look at a few numbers to get a full view of all enrollment in QHPs. First up Special Enrollment Period (SEP) enrollees, while most people are only eligible to enroll in ACA exchange coverage during the official OEP, anyone who experiences a Qualifying Life Experience (QLE) such as losing their existing healthcare coverage due to job loss, moving to another state, getting married/divorced, giving birth/adopting a child, etc. is eligible for a 60-day SEP regardless of the time of year.

Before the COVID pandemic hit, typically around 5,800 people would enroll via SEPs each and every day nationally. CMS confirmed that 266,434 enrolled via 36 HealthCare.Gov states alone from 2/15 – 4/30 in 2019 but this number does not include 14 State Based Exchange states or DC.

As reported by 673,141 more people have enrolled in Qualified Health Plans in FFM states during that same time period this year. If we add California, New York, Pennsylvania, New Jersey, Washington State and the other 10 state-based exchanges, the total 2021 SEP enrollments as of late April 2021 is around 1.5 million, 1.0 million higher than the largest recorded ACA enrollment which was in 2016.

The Centers for Medicare & Medicaid Services (CMS) reports that 940,000 Americans have signed up for health insurance through since February 15, the start of the 2021 Marketplace Special Enrollment Period (SEP) opportunity, through April 30, with approximately 469,000 consumers signing up for health insurance in the month of April. The number of new plan selections from the start of the SEP opportunity on February 15 through April 30 represents a substantial increase in enrollment from the same period in 2020 and 2019, when 391,000 and 266,000 consumers signed up for Marketplace coverage, respectively.

In previous years, SEPs were available primarily only for qualifying life events, whereas this year the Biden-Harris Administration opened a SEP to all Americans in response to the COVID-19 Public Health Emergency. Under the American Rescue Plan (ARP), most consumers are now eligible for more generous advance payments of premium tax credits (APTC), which further reduce monthly premiums. Since implemented the expanded APTC amounts on April 1, approximately 1.9 million consumers have returned to the Marketplace and reduced their monthly premiums after APTC by over 40 percent, from $100 to $57, on average.

The ARP also makes it more affordable for new consumers to purchase and use Marketplace coverage. For new consumers selecting plans during the SEP, the average monthly premium after APTC fell over 25 percent, from $117 for those enrolling from February 15 through March 31 to $86 for those enrolling from April 1 through April 30. The ARP also helped to lower out-of-pocket costs for new consumers. The median deductible for new consumers during the SEP fell by nearly 90 percent, from $450 prior to April 1 to $50.

FFM Plan Selection and Application ActivityFeb. 15 –Apr. 30, 2021
New Plan Selections939,575
New Consumers Requesting Coverage on an Application Submitted on or after February 151,738,781
Marketplace Eligible1,477,254
Medicaid/CHIP Eligible256,813
New Plan Selections by FFM StateFeb. 15 – Apr. 30, 2021Feb. 15 – Apr. 30, 2020Feb. 15 – Apr. 30, 2019
North Carolina55,12220,48413,691
North Dakota2,3991,216817
New Hampshire4,1892,3121,834
New Mexico4,0261,8551,441
South Carolina27,1948,3455,036
South Dakota3,3161,3741,036
West Virginia1,9081,091780


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