Marketplace Sign-ups Increased by 21% in 2022

The Biden Administration announced 14.5 million people have signed up for Affordable Care Act Marketplace coverage for 2022. This represents a 21% increase in Marketplace sign-ups over last year. Three states (Massachusetts, Kentucky, and Hawaii) and Washington, DC, saw enrollment decrease from 2021 to 2022. The remaining 47 states saw Marketplace enrollment increase, ranging from 1% in Rhode Island to 42% in Texas. In 20 states, enrollment increased by more than 20%.

In terms of numbers of people, Florida saw the biggest increase with 603,000 more sign-ups than last year. That was followed by Texas (549,000) Georgia (184,000), California (156,000), and North Carolina (134,000). In the places where enrollment shrunk, sign-ups decreased by 31,000 in Massachusetts, followed by Kentucky (-4,000), Washington, DC (-1,000), and Hawaii (less than 600).

The increase in Marketplace enrollment is due to expanded premium subsidies for 2021 and 2022 passed through the American Rescue Plan Act (ARPA), and increased efforts to enroll eligible people. ARPA increased premium subsidies for eligible enrollees and made premium subsidies available to middle-income enrollees to purchase coverage through Marketplaces. Additionally, the Biden Administration increased marketing and outreach efforts, including by increasing navigator funding and extending open enrollment by 30 days.

Of note, the reported enrollment is based on the number of people who signed up for coverage on state and federal Marketplaces through January 15, 2022. Open enrollment is ongoing beyond January 15 in some state Marketplaces (including California, Kentucky, Maryland, New Jersey, New York, Rhode Island, and DC). Colorado, Maryland, New York, and DC have also established special enrollment periods for the COVID-19 pandemic that allow uninsured people to buy coverage outside of the open enrollment period. Therefore, final Marketplace sign-ups for 2022 may be higher.

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