New HHS Report Shows National Enrollment Period Rate Reached All-Time Low in 2023 After Record-Breaking ACA Enrollment Period

The U.S. Department of Health and Human Services (HHS) released a new report showing that the national uninsured rate reached an all-time low of 7.7 percent in early 2023. Approximately 6.3 million people have now gained coverage since 2020, coinciding with the beginning of the Biden-Harris Administration in January 2021.  This is the first report on the uninsured rate since the historic ACA Open Enrollment period that ended this past January. The success of that enrollment period, during which a record-breaking 16 million Americans enrolled in coverage through HealthCare.gov or state websites, helped the nation’s uninsured rate reach a historic low, breaking last year’s record.

The Biden-Harris Administration has also been working to help Americans keep their coverage, including as Medicaid coverage renewals begin for the first time in three years. Secretary Becerra and others in the Administration have repeatedly called on states and other stakeholders to take action to protect coverage.

“The Inflation Reduction Act has played a critical role in helping more Americans afford coverage through the Affordable Care Act. And this year, the nation’s uninsured rate reached an all-time low, even breaking last year’s record,” said HHS Secretary Xavier Becerra. “HHS will continue to do everything we can to help Americans keep or get coverage and have access to quality, affordable health care.”

The report, which analyzes data from the National Health Interview Survey and American Community Survey, shows the dramatic impact of Biden-Harris Administration’s efforts to increase health care access and lower costs for America’s families.  The success is due to President Biden’s historic American Rescue Plan’s enhanced Affordable Care Act (ACA) subsidies and the Inflation Reduction Act’s extension of those subsidies, the continuous enrollment condition in Medicaid, several recent state Medicaid expansions, and substantial enrollment outreach by the Administration in 2021-2023.

Key findings from today’s report, published by HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE), include the following:

• The nation’s uninsured rate declined significantly in early 2023, relative to 2020, reaching an all-time low of 7.7 percent for U.S. residents of all ages in the first quarter (January-March) of 2023, based on new data from the National Health Interview Survey.
• Approximately 6.3 million people – including 5.5 million adults ages 18-64 and 0.7 million children ages 0-17 – have gained health coverage since 2020.  These gains in health insurance coverage are concurrent with the implementation of the American Rescue Plan’s enhanced Marketplace subsidies, the Inflation Reduction Act’s continuation of those subsidies, the continuous enrollment condition in Medicaid, recent state Medicaid expansions, and substantial Marketplace enrollment outreach by the Biden-Harris Administration in 2021-2023. 
• Uninsured rates among adults ages 18-64 declined from 14.5 percent in late 2020 to 11.0 percent in early 2023.  The uninsured rate among children ages 0-17, which had increased during 2019 and 2020, fell from 6.4 percent in late 2020 to 4.2 percent in early 2023.
• Approximately 5.8 percent of adults ages 18-64 reported having Marketplace coverage in early 2023 compared to 4.4 percent in 2020. 
• Changes in uninsured rates from 2020 to 2023 were largest among individuals with incomes below 100% of the Federal Poverty Level (FPL) and incomes between 200% and 400% FPL. These gains follow record breaking sign-ups for health coverage in the ACA Marketplaces during the 2022/2023 Open Enrollment Period, with the increased Marketplace enrollment contributing to the substantial growth of private coverage.
• These results highlight the significant gains in health insurance coverage that occurred in 2021, 2022 and early 2023 associated with the Biden-Harris Administration’s policies to support health insurance expansion. These gains build on the large reductions in the uninsured rate that occurred after the implementation of the ACA in 2014, which research demonstrates produced improved health outcomes, access to care, and financial security for families. 
• These results are likely to mark the low point in the uninsured rate in 2023.  Each year, the first quarter of the year generally marks the lowest uninsured rate, as people transition to new sources of coverage, or periods without insurance coverage, over the remainder of the year.  In addition, in April of 2023, the Medicaid continuous coverage condition came to an end, so some people will transition out of Medicaid coverage, including to other sources of insurance coverage, over the coming months.

To read the entire report, click here: https://aspe.hhs.gov/reports/national-uninsured-rate-reaches-all-time-low-early-2023

This year, as Medicaid returns to normal eligibility rules following the end of the COVID-19 Public Health Emergency, many Americans are likely to transition out of Medicaid coverage. The Biden-Harris Administration is taking a whole-of-government approach to ensure that those who are eligible for Medicaid remain covered by the program, and those who are not transition to other forms of coverage through HealthCare.gov, their employer, or other options. The Administration wants to make sure people stay covered whether that’s through Medicaid, Medicare, the Marketplace, or employer-sponsored coverage. For more information about the redetermination process, please visit Medicaid.gov/unwinding.