Obamacare sign-ups hit record highs as Republicans renew repeal effort

The Department of Health and Human Services announced on Jan. 10 that in the most recent open enrollment period, more than 20 million people selected a health insurance plan on the Affordable Care Act marketplace, a record high.

The current enrollment period began Nov. 1, 2023, and ends on Jan. 16. The data released by HHS includes sign-ups that occurred between Nov. 1 and Dec. 23.

“More people with access to preventive care means a healthier country and lower health care costs across the board,” HHS Secretary Xavier Becerra said in a statement.

In Pennsylvania, there were 407,027 sign-ups via Pennie, the state’s health insurance marketplace. Eighteen states and Washington, D.C., had people sign up via state-based exchanges, while sign-ups in 32 states were conducted on the national health insurance portal, HealthCare.gov.

These marketplaces were created by the Affordable Care Act of 2010, also known as Obamacare, which was signed into law by former President Barack Obama. President Joe Biden, who served as Obama’s vice president, has been a longtime advocate of the law.

“Thanks to efforts by my Administration, millions of Americans are saving hundreds or thousands of dollars each year on health insurance premiums, and most people who shop for coverage at HealthCare.gov can find a plan for $10 a month or less,” Biden said in a statement.

Biden urged more people to sign up for coverage before the end of the enrollment period and criticized Republicans for pushing for repeal of the law. Biden noted that repeal would strip coverage from over 20 million people, end Medicaid coverage for many, and allow insurance companies to resume denying coverage to those with preexisting conditions, a practice which is prohibited under the current law.

“That would be a catastrophe for families who would face skyrocketing health care costs. I won’t let it happen on my watch,” Biden said. “As too many Americans know: access to quality, affordable health care can mean the difference between life and death, and hope and fear.”

Former President Donald Trump, the leading candidate for the Republican Party’s presidential nomination, has endorsed repealing the law.

“The cost of Obamacare is out of control, plus, it’s not good Healthcare. I’m seriously looking at alternatives. We had a couple of Republican Senators who campaigned for 6 years against it, and then raised their hands not to terminate it. It was a low point for the Republican Party, but we should never give up!” Trump wrote in a social media post in November 2023.

When he was in office in 2017, Trump attempted to repeal the law, and a bill that would have repealed it passed the Republican-controlled House but failed to pass in the Senate. 

Trump has never offered an alternative or replacement health care plan. In 2015, after he began his first presidential campaign, Trump said he would replace the health care program with “something terrific.” He did not propose any related ideas in subsequent years. Then, on July 19, 2020, during his failed reelection campaign, he said he would sign a replacement plan in “two weeks,” but never did. 

Trump’s opposition to the law runs contrary to public sentiment.

A May 2023 KFF poll showed that 59% of American adults had a favorable opinion of the law, while only 40% disapproved of it. Among political independents, approval was at 62%, while 89% of Democrats and 26% of Republicans supported the law. Public support for the law has increased since its passage in 2010, and a majority of Americans have had a favorable view of the law since 2017, as Republican repeal efforts were intensifying.