Uninsured Would Drop By 4.2M If Rescue Plan Subsidies Were Permanent, Study Says

The number of uninsured in the United States would fall by 4.2 million if policymakers made a temporary provision in the American Rescue Plan Act (ARPA) permanent, a new analysis shows. The provision enhances subsidies to make coverage in the Affordable Care Act (ACA) marketplace more affordable.

Urban Institute researchers, with funding from the Robert Wood Johnson Foundation, predict a majority of previously uninsured individuals would be attracted to the marketplace due to the enhanced subsidies, estimating subsidized enrollment would increase by 5.1 million. Additionally, roughly 317,000 people with non-ACA-compliant coverage would switch to a more comprehensive ACA-compliant plan if they were to become newly eligible. These estimates translate to a 60 percent increase in marketplace enrollment in 2022 if the ARPA were to become permanent.

Earlier estimates predicted that 3.5 million people would become uninsured due to a COVID-19-related job loss by the end of 2020 and definitive data are not yet available to know how many people actually lost coverage. Researchers say that considering the permanency of the ARPA’s temporary policy changes offers potential solutions for regaining coverage lost during a tumultuous year and further improving the stability of the marketplace.

“Making the enhanced ACA subsidies in the American Rescue Plan Act permanent would have a dramatic effect on both coverage and affordability,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. “Enhancing premium tax credits could positively impact the marketplace, leading to greater insurer participation and resulting in lower premiums. That’s good news for consumers and insurers.”

The ARPA allows people with incomes over 400 percent of poverty eligibility for subsidies to purchase insurance coverage from the ACA marketplace. The law increases financial assistance for people at lower incomes who were eligible under the ACA. Both provisions last for two years, retroactive to Jan. 1, 2021.