ACA Sees Enrollment Spike Due to COVID-19

The COVID-19 pandemic has changed many aspects of everyday life, including health insurance. The ACA saw its enrollment increase for the first time in many years due to the effects the pandemic is having on people's health insurance coverage.
By Alexandra C.
Updated Jan 28, 2021
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  • More people signed up for Obamacare on the federal healthcare exchange during open enrollment for 2021, making it the only increase under the Trump Administration, which has long tried to eliminate the landmark health reform law.

  • According to federal data, nearly 500,000 Americans turned to the federal Obamacare exchanges after losing health insurance coverage in 2020.

  • Five states experienced double-digit growth in ACA sign-ups, with Texas leading the way at 15 percent.

The COVID-19 pandemic has significantly changed many aspects of everyday life. It’s impacting another area, too: health insurance. In fact, the Affordable Care Act (ACA) saw its enrollments increase for the first time under the Trump Administration. Policymakers say this is largely from layoffs, economic turmoil, and people losing employer-sponsored health insurance due to COVID-19.

What Is the Affordable Care Act?

The Affordable Care Act, often dubbed “Obamacare,” is the name for the comprehensive health care reform law that was passed under President Barack Obama. Individuals and families who do not get healthcare coverage through their employer or Medicare/Medicaid can get coverage via the ACA marketplace. Given the devastating impact the coronavirus is having on the U.S. economy, the ACA plays a crucial role in helping Americans keep their health insurance amid the ongoing pandemic.

According to the Centers for Medicare and Medicare Services, nearly 8.3 million Americans chose healthcare plans for 2021 in 36 states that use This enrollment increase comes as the Supreme Court considers whether to overturn the law and as the nation finds itself in the worst period yet of the COVID-19 pandemic.

Overall, ACA sign-ups were actually slightly less for 2021 coverage than for the year before. But the prior data included New Jersey and Pennsylvania. Both of those states shifted to their own marketplaces for 2021’s coverage period. So, when you remove those states and Nevada, which set up its own exchange for the 2020 enrollment period, plan selections increased by 6.6 percent from last year and 6.3 percent from 2019.

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According to the U.S. Department of Health and Human Services, economic and health impacts caused by the COVID-19 pandemic have left states facing increases in new applications for health insurance through both Medicaid and the ACA Marketplace.

Health insurance policy experts are linking the significant growth in ACA enrollments to COVID-19 and its impact on American jobs and the economy. They believe that many Americans who lost their employer-based insurance coverage due to COVID-19 are shifting to ACA coverage. 

When we look at the data earlier in 2020, when COVID-19 was just beginning its warpath in the U.S., sign-ups spiked even more. In April, sign-ups spiked to more than double what the numbers were in past years, as millions of Americans started losing their jobs amid the coronavirus pandemic. Overall, enrollment jumped 46 percent in the first five months of 2020 compared to the same period the year before.

See more in our Guide to Health Insurance Enrollment.

ACA Enrollees Stick With Their Plans

The steady growth in ACA enrollment also pertained to current Obamacare enrollees. Figures show that 6.4 million current enrollees in the ACA selected plans or were automatically re-enrolled for 2021, an unprecedented increase of 10.6 percent from the prior year.

More Data Coming

It’s possible that enrollment will increase even more because, at this time, data from CMS does not account for customers who enrolled in coverage between midnight and 5 a.m. ET on December 16 or who are still eligible to enroll after leaving their contact information at the call center due to high volume. This data also does not reflect enrollment in many state-based marketplaces whose deadlines are later, in December or January. According to CMS, the final enrollment report will be released in March, along with final data on plan selection for state exchanges no longer on

Newly inaugurated President Joe Biden, who served as V.P. under the namesake of Obamacare, plans to expand the Affordable Care Act. Data shows that the majority (62 percent) of the public wants the Biden Administration to build on ACA or keep it as is. Now, policymakers wait to see if under the Biden Administration the Affordable Care Act continues to experience unprecedented growth.