11 Years After ACA, Millions Still Fall Through Cracks

Number of the Day: The most relevant or interesting figure in personal finance

32 Million

That’s roughly how many people under age 65 are estimated to be without health insurance 11 years after the Affordable Care Act was passed as a path to providing everyone with a coverage option. 

The Affordable Care Act (ACA), enacted exactly 11 years ago—on March 23, 2010—set up a system where the government helps Americans buy private health insurance plans through public exchanges, offering subsidies for lower-income households. While there were about 50 million people under 65 going without insurance the year it was signed into law, according to a Congressional Budget Office estimate at the time, a September 2020 CBO report estimated there would be close to 32 million uninsured in 2021. (Most of those 65 and over are covered by Medicare.) 

But that’s still far short of former President Barack Obama’s stated goal of providing every American with basic healthcare. And the COVID-19 pandemic has put further strain on the system, with some ballparking that 2 million to 3 million people lost their employer-provided health insurance just between March and September of 2020.

In response to the emergency, President Joe Biden has expanded the ACA, creating a special enrollment period that lasts until May 15 and enacting legislation—the American Rescue Plan—that increased and expanded eligibility for insurance premium subsidies. 

“We are one of the few countries on earth with this much wealth that does not provide health insurance as a just basic right to its citizens, and the Affordable Care Act and now the American Rescue Plan have closed that gap, but there’s still folks falling through the cracks,” Obama said at an event Monday.