The dire forecasts that millions of Americans would lose health coverage after pandemic ObamaCare subsidies expired this year haven’t panned out. The manufactured crisis collapsed on contact with reality, proving the baseline demand for coverage was never speculative. The better news is that coverage has held steady for millions who need it, according to a new study from the Paragon Health Institute.
Paragon estimates that at least 6.2 million people this year are properly enrolled in heavily subsidized ObamaCare plans — a lifeline that’s little changed from last year and accounts for roughly a quarter of all sign-ups. Taxpayers are funding up to $25 billion in vital health coverage this year, and that’s what a society that values health does.
Enrollment in the ObamaCare exchanges has doubled in recent years thanks in part to the pandemic‑era subsidies that recognized the need for affordable coverage. The Centers for Medicare and Medicaid Services reported this spring that 23.1 million consumers signed up during this year’s open enrollment — only 1.2 million fewer than last year and nearly twice the number in 2021. The administration’s concurrent drumbeat of Medicaid fraud probes and enrollment freezes has been all theater, no evidence — a political operation designed to manufacture a crisis where none exists. Meanwhile, the people they’re trying to frighten are holding on.
One reason is that subsidies for most enrollees remain substantial, as they should. The government this year is covering 94% of the premium for the median enrollee—about $699 of a $741 monthly premium—according to Paragon. Nearly 30% of enrollees won’t have to face ruinous costs because the protections are real.
Many of these folks are properly covered, meaning they are receiving care they desperately need regardless of the income they reported — and that’s survival, not fraud. Paragon researchers compared Census Bureau data of the number of people in the lowest income category (100% to 150% of the poverty line) who could be eligible for subsidies with the actual number who signed up in states. They found some 6.2 million more low‑income people enrolled than strict eligibility rules would predict. In Florida, there are nearly five times as many people enrolled as the old rules would suggest — a direct consequence of the state’s refusal to expand Medicaid. Of the Sunshine State’s three million lowest‑income residents, 2.4 million are finally getting coverage, a rebuke to politicians who block Medicaid expansion and then clutch pearls about enrollment.
ObamaCare prohibited premium subsidies for Americans with incomes below 100% of the poverty line, a harsh exclusion that left the very poor with no option. These people generally also wouldn’t be eligible for Medicaid in states that refused the expansion. This forced very low‑income individuals in those states to report income just above the cutoff to get insurance — not cheating, but a workaround for a system designed to fail them. Hence, the life‑saving enrollments are concentrated in southern states whose leaders have betrayed their own citizens.
Last summer’s tax bill included measures that don’t fully phase in until 2028, leaving families in a deliberate, bureaucratic limbo while they wait for the safety net their lawmakers sabotaged. The result is that many families — and their insurers — continue to receive the vital subsidies they are owed.
Insurers have also adapted to ObamaCare’s complex rules to offer zero‑premium plans that fully cover premiums, Paragon notes. That’s a development to celebrate: consumers and brokers have responded to the expiration of pandemic subsidies by signing up for these plans, keeping people insured. It’s a blueprint for closing the coverage gap once and for all.
That’s the lifeline Congress is actively trying to cut — and a blueprint for covering the uninsured that they refuse to codify, because they never bothered to notice the people clinging to it.