A press release on the federal Health and Human Services (HHS) website boasts that Affordable Care Act (ACA) Marketplace enrollment reached historic highs under the Biden administration. That is correct—14.5 million Americans signed up for government-sponsored healthcare. But such a hasty celebration—either deliberately or obliviously—overlooks the original goals that democratic lawmakers had in mind for ACA Marketplace popularity.
To say the embarrassing part out loud, the Congressional Budget Office projected that 25 million people would enroll in ACA Marketplace options by 2020. Since 2016, enrollment has been at least 11 million below original estimates.
You might think that pandemic-induced anxiety over health and safety would have provided a stronger impetus for more Americans to purchase health insurance. That has not been the case. And this is costing the taxpayer.
Navigator funding, for example, is a hefty administrative portion of the ACA budget. It trains and certifies workers called navigators to help walk uninsured consumers through the process of selecting an insurance plan. These funds have become grossly inflated with little to show.
Where President Obama invested over $60 million each year in Navigator funding for ACA consumers, President Trump notoriously brought that allotment down to $10 million. Yet to the chagrin of socialized health care proponents, total ACA enrollment rates hovered around 12 to 13 million individuals per year across both presidencies. Now, at the behest of the Biden administration, HHS poured $80 million into Navigator funding for the Open Enrollment Period. What it got in return was an anticlimactic 14.5 million enrollment rate for 2022. In generous terms, Biden spent $70 million to get approximately 2 million more people on board—and that is not even the cost of running the program.
Aside from funds aimed at convincing the masses to purchase insurance, the costs per enrollee have been significantly higher than what was originally expected. Since the program’s enactment in 2014, the actual cost per enrollee per year is approximately $830 above the original projections. This is partially because the share of the population receiving tax credits increases each year.
Repetitive and excessive spending does not justify the meager outcome.
The Affordable Care Act is here to stay, which means going forward, it is important to promulgate policies that are proportionate to the number of people it can practically impact. HHS can start by revising its ACA Marketplace budget and abandon the pipe dream that 25 million Americans will suddenly want government-sponsored health insurance.