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A Look at 10-Years of ACA Coverage

March 25, 2024

Pennsylvania and its state peers continue to see coverage gains on the Affordable Care Act (ACA) health insurance marketplaces.

This month, the U.S. Department of Health and Human Services (HHS) released four reports looking at insurance coverage in the first decade of the ACA, noting significant progress since the law went into effect during 2014.

“The marketplaces have become a pillar of American society, a guaranteed place where people can find affordable, quality coverage,” said HHS Secretary Xavier Becerra.

Here’s what you need to know:

  • By the numbers:  About 21.4 million consumers selected or were automatically re-enrolled in health insurance coverage during 2024 open enrollment, a 31 percent increase compared to the year before.
  • In Pennsylvania:  In five years, Pennsylvania's enrollment in its state-based exchange has grown from 331,000 plan selections to 434,000.
  • Then and now:  The U.S. uninsured rate was 14.5 percent during 2013 and 8 percent during 2022. In Pennsylvania, the rate went from 9.7 percent to 5.3 percent in that time.
  • Tax credits:  About 9.6 million more consumers are receiving premium tax credits to help lower the cost of coverage compared to 2021.
  • Total savings:  Nationally, most consumers qualify for $0 premiums or are seeing annual premium savings exceeding $800 through provisions in the Inflation Reduction Act and the American Rescue Plan.

“As we look back and celebrate the historic achievements of the Affordable Care Act, the law continues to live up to its purpose of providing affordable, quality health care coverage to Americans,” said CMS Administrator Chiquita Brooks-LaSure said in a statement. “Gone are the days when being a woman was considered a pre-existing condition or sick children could be denied health insurance.”

The four reports—on plan selection, trends and state estimates, enrollee demographics, marketplace evolution—are available online.