Crush of Obamacare signups expected before deadline

How the coronavirus pandemic left millions of Americans without health insurance

Tuesday is the last day to sign up for Obamacare in 36 states, while another 14 and Washington, D.C. have later dates. The federal health insurance program — accessible at healthcare.gov — has seen a crush of signups as the open enrollment deadline approaches, and coronavirus cases continue to surge. 

Over 915,000 people signed up for Obamacare from November 29 to December 5, the fifth week of open enrollment and most recent data released by the Centers for Medicare & Medicaid Services' weekly enrollment snapshot. That's nearly double the week prior, when 523,020 people selected plans, which itself was about a 50% increase from the same time period last year.

According to CMS, about 8.3 million people enrolled or were automatically re-enrolled in the program during the 2020 open enrollment period, over 2 million of whom were "new consumers." And, as of June 2019, 14 million people who were made newly eligible for coverage under the ACA's Medicaid expansion, adopted by 39 states, enrolled in coverage, according to data from the Kaiser Family Foundation.

More than 300,000 people have now died from the coronavirus in the U.S., according to data from Johns Hopkins University. The U.S. has set records for COVID-19 hospitalizations for eight days in a row, and the number of patients requiring intensive care is up 80% from a month ago. 

Coverage for those who make the deadline will begin January 1, a handful of weeks before the program's most prominent opponent, President Trump, leaves office. Mr. Trump campaigned on "repealing and replacing" Obamacare during the 2016 election, and kept on message, albeit unsuccessfully, throughout his presidency. 

In June, when close to half a million Americans had lost health insurance through their employer due to the economic shutdown brought on by the pandemic, the Trump administration urged the Supreme Court to overturn the Affordable Care Act, which authorized Obamacare. By August, the number of Americans who had lost their health insurance jumped to six million — or, at least 12 million when spouses and children are taken into account, according to research from the Economic Policy Institute.

At the center of the case before the Supreme Court is the constitutionality of the so-called "individual mandate," an original statute of the act that required those who could afford health insurance, but opted out, to pay a fee when they filed taxes. Congress passed tax legislation in 2017 that eliminated the unpopular fine, and a federal appeals court determined the mandate was unconstitutional at this time last year. Texas and other conservative-led states have since argued that the mandate's unconstitutionality renders the entire ACA unconstitutional. 

That argument, however, has not exactly been met with a warm reception by the conservative majority on the Supreme Court. Last month, Chief Justice John Roberts and Justice Brett Kavanaugh, one of three justices appointed by President Trump, both signaled they disagree with arguments made by the Republican-led states.

Roberts said he believes that if Congress had wanted the full act to fall, it would have struck it down itself, adding that it's not the Supreme Court job's to do so. "It's hard for you to argue that Congress intended the entire act to fall if the mandate were struck down when the same Congress that lowered the penalty to zero did not even try to repeal the rest of the act," Roberts told Texas Solicitor General Kyle Hawkins, who argued on behalf of the 18 red states challenging the law.

A final decision from the court is expected by June. 

Analysts and advocates who follow Obamacare sign-ups say interest in the program has only grown stronger as the coronavirus pandemic holds its grip on the nation, The Associated Press reports.

President-elect Joe Biden has nominated California Attorney General Xavier Becerra to serve as his first secretary of health and human services. Becerra was a leading advocate for passage of the ACA as California's attorney general, and has defended the law in federal court, including before the Supreme Court.

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