Yesterday, the Centers for Medicare and Medicaid Services released the final enrollment for the 2024 Open Enrollment Period for the ACA:
| Marketplace and Consumer Type | Cumulative 2024 OEP Plan Selections |
| Total: All Marketplaces | 21,310,538 |
| New Consumers | 5,045,290 |
| Returning Consumers | 16,265,248 |
The Confederacy has substantial market share. The four big states of North Carolina, Georgia, Florida and Texas have 47% of all national enrollment. A lot of this is that three of these four states have yet to expand Medicaid. However, even North Carolina with recent Medicaid Expansion has enrollment several times the per-capita rate of California, the largest state based market place.
| State | Platform | Enrollees | National Share |
| Florida | HealthCare.gov | 4,211,902 | 19.8% |
| Georgia | HealthCare.gov | 1,305,114 | 6.1% |
| North Carolina | HealthCare.gov | 1,027,930 | 4.8% |
| Texas | HealthCare.gov | 3,484,632 | 16.4% |
Over a quarter of 18 to 64 year olds in Florida have an on-market ACA plan. Enrollment is very high in a swing state (GA) and a light pink state (NC) so the question I would ask my masters’ students is “Is this enough to think that the ACA has become entrenched?”
Baud
Let’s not run the experiment that would give us the answer.
David Anderson
@Baud: Agreed, but this is a good prompt for public policy students to integrate what they know from multiple domains
JCJ
I doubt it. The politicians who would vote to repeal the ACA would not be affected personally and they are likely at no risk for losing an election. They might be at risk of losing a primary if they don’t vote to repeal the ACA
Baud
@JCJ:
They also don’t have to repeal it completely. They can weaken it and send it into a death spiral. Hands cleaner that way.
Elizabelle
@Baud: Don’t give them any ideas.
I hope that we have a blue tsunami in 2024. Continue some long-needed corrections.
Steve in the ATL
@Baud: the John Roberts Special
jonas
It would be interesting to know the racial breakdown of these enrollments. If the ACA is “entrenched” mostly among African Americans or other minorities, then of course the states’ white (mostly Republican) politicians will not give a shit about trying to dismantle it.
C Stars
Do Dems running in FL and GA talk about this at all?
3Sice
Are there billionaires who can piece off politicians for pennies on the dollar and steer the monies into their pockets?
rikyrah
How many are still without coverage due to Red State Governors refusing to expand Medicaid?
cain
@Baud: merge the congressional healthcare with the ACA. Repeal one it repeals the other. Weaken it and weaken the other.
lowtechcyclist
@jonas:
All too true. “Why should our tax dollars go to help Those People?“
Baud
@cain:
Congressional healthcare has always been merged with the ACA. But the GOP can change that.
Mai Naem mobile
@rikyrah: its down to 10 states(Al, Miss, GA, Fl, SC, WY, TX, KS. TN, WI.) I didn’t realize Wisconsin hadn’t expanded Medicaid. I guess if the Dems manage to flip the state legislature, it would happen?? I don’t recall any of the WiscDem/Ben Wikler stuff mentioning that which surprises me.
Mousebumples
@Mai Naem mobile: Even without un-gerrymandering, it’s not a guarantee that we’ll flip both houses of the State Leg. I’m hopeful, but we don’t have maps yet, either.
I’m guessing it’s a don’t promise what you can’t deliver. I would expect it to be in messaging for Nov 2024 with new maps in place, however.
Betty
It would be interesting to see how the numbers are affected by the availability of employer-sponsored health care and the presence of unions.
Yarrow
@Baud: That’s what they’re doing with traditional Medicare as the insurance companies now run Medicare Advantage programs.
Brachiator
The answer is probably “No.”
Republicans are committed to dismantling the ACA. They don’t care who it hurts. They will try to substitute something like vouchers and sell it as good enough.
Brit in Chicago
“Entrenched” is a pretty vague term, but I’d say that it would require that most people who benefit from the ACA understand that that’s where their health insurance comes from. I don’t really know, but my guess is that we’re pretty far short of that.
Fake Irishman
@Mai Naem mobile:
WI hasn’t expanded Medicaid, but it doesn’t have a Medicaid gap of folks who fall below the poverty line and aren’t eligible for subsidies. Prior to Scott Walker, WI Medicaid for parents was really generous in its eligibility level. After the ACA passed the GOP legislature didn’t expand Medicaid but cut back BadgerCare eligibility for parents to 100 percent of the poverty line so they could raise the eligibility level to 100 percent FPL for childless adults. It was an awkward compromise that left some federal money on the table, but at least gave everyone some access to affordable insurance.
so yeah, Dems in WI do want to expand Medicaid, and it’s is a campaign issue, but folks aren’t falling through the cracks in the way they are in Texas and Florida.
Fake Irishman
@Brit in Chicago:
Perhaps not everyone gets it, but There is signal in the noise. I’m aware of some literature that connects Mediciad expansion with higher voter turnout for Dems among beneficiaries, even in deep red states. There’s also the fact that the GOP got mauled in the 2018 House elections over trying to repeal the ACA.
They still may try though.
Barbara
@Brit in Chicago: Another data point is that every enrolled person has non-enrolled friends and family members or co-workers or even employers who are aware of the importance of the ACA. I do not expect small employers who are relying on the ACA to provide insurance for their employees to automatically vote for Democrats, far from it, but the resonance of the ACA as an issue should go down considerably. I can remember being called by someone seeking donations for a Republican candidate based on my presumed shared opposition to ACA, and after I got over the shock (why the heck are you calling me?) I decided to debate the guy and let’s just say that I quickly got him into the corner of “well I guess we’ll just have to agree to disagree” and “I guess you’re not going to donate today,” umm, yeah, that would be a big no. And you might consider taking me off your list so you don’t waste your time
In other words, the presumption that you can motivate people by their opposition to the ACA is going to go way down. As I told that guy, the ACA was benefiting three members of my family so how did he think I would feel about it?