(CNN) — Americans are flocking to sign up for 2021 health coverage on the Obamacare exchanges, but the window is closing fast. Open enrollment in the 36 states that use the federal exchange, healthcare.gov, ends on Tuesday.
More than 3.8 million people selected plans through December 5, according to the most recent federal data, despite a looming Supreme Court challenge. The average number of consumers signing up daily is running about 14% ahead of last year’s pace.
Just how many people ultimately choose coverage on the Affordable Care Act exchanges won’t be known until early next year. Some of the 14 states, plus the District of Columbia, that run their own exchanges have longer open enrollment periods that stretch into January.
This year marks the first time the Obamacare exchanges’ role as a health insurance safety net amid an economic downturn is being tested. Health policy experts expect that some Americans who lost their job-based coverage as a result of the coronavirus pandemic are shifting to Affordable Care Act policies.
The decline in employer-sponsored insurance is far less than the overall decline in employment, according to a recent Kaiser Family Foundation report. It estimates that roughly 2 to 3 million people lost work-based insurance between March and September.
Enrollment in Obamacare remained fairly steady during that period, though typically it drops over the course of the year. More people signed up during special enrollment periods than usually do.
Meanwhile, Medicaid enrollment increased by 4.3 million people from February through July, according to preliminary federal data. Some 38 states, plus the District of Columbia, have expanded Medicaid to low-income adults, a key provision of the Affordable Care Act.
Obamacare enrollees renew coverage
Current Affordable Care Act enrollees, who make up the bulk of those who’ve selected policies at 2.9 million, are renewing coverage at a faster pace than in recent years. Nearly 83,000 returning consumers signed up each day since enrollment began on November 1, on average, compared to 70,400 last year.
Those who don’t select plans will be automatically enrolled in the same policy or a comparable one.
The number of new customers is running slightly ahead of last year, but there’s been a sizable increase over the past two weeks, said Josh Peck, a former Obama administration official and co-founder of Get America Covered. Nearly 916,000 new people have signed up so far, but the majority of new consumers pick plans in the final days of open enrollment.
Sign-ups are stronger than they appear because this year’s open enrollment figures do not include Pennsylvania and New Jersey, which established their own exchanges for 2021. Together, they accounted for about 7% of customers last year, Peck said.
Supreme Court determining Obamacare’s fate
Enrollment is taking place as Supreme Court justices are considering the fate of the landmark health reform law. The justices heard oral arguments in a case seeking to invalidate the Affordable Care Act on November 10.
A coalition of Republican state attorneys general led by Texas and joined by the Trump administration are arguing that the individual mandate is unconstitutional because Congress reduced the penalty for not having health insurance to zero as part of the 2017 Republican tax cuts — and that the entire law must fall as a result.
Chief Justice John Roberts and Justice Brett Kavanaugh suggested that it wasn’t the Supreme Court’s role to toss out the whole law even if one or more provisions are deemed unconstitutional, signaling the Affordable Care Act will survive the court challenge.