Why the impressive new ACA enrollment numbers matter

The Affordable Care Act is working well, it’s about as popular as it’s ever been, and as of this week, enrollment data suggests the winning streak is far from over. Reuters reported:

Note, the deadline for enrollment isn’t until Jan. 16, 2024.

For health care advocates, the data is encouraging on its own, and it reflects what’s possible when congressional Democrats lower premiums and an administration commits to covering as many Americans as possible.

But more so than at any point in recent years, there’s a political dimension to this that matters nearly as much. When the data from the Department of Health and Human Services was released, President Joe Biden’s re-election campaign issued a statement reminding the public about the stakes.

“Today’s announcement showing a record-breaking enrollment pace through the Affordable Care Act is historic and should be a moment of celebration of how far we’ve come thanks to President Biden and Democrats’ work to ensure access to quality, affordable health care for millions,” the press release read. “But looming in the shadows is the very real and dangerous threat of a second Donald Trump presidency ripping it all away.

“If Trump gets his way, tens of millions of Americans could lose their health care and drug prices and insurance premiums would skyrocket. His effort to repeal the Affordable Care Act could mean that insurance companies would no longer be forced to cover those with preexisting conditions like asthma or diabetes, young people could be kicked off of their parents’ health care, preventative care like cancer screenings and contraception would no longer automatically be covered, and so much more.”

It’s not exactly a secret that Democrats would love for health care to be a central issue of the 2024 elections, and to the party’s delight, Republicans have spent the last month or so helping advance the Democratic strategy.

Trump, for example, who’d largely ignored the ACA since leaving office nearly three years ago, has begun going after “Obamacare” in increasingly explicit terms. Soon after, former Ambassador Nikki Haley also appeared to open the door to repealing the ACA.

Earlier this month, Florida Gov. Ron DeSantis also said he intends to “replace“ the nation’s existing health care system with an alternative he’s not prepared to share.

What’s more, as we’ve discussed, some congressional Republicans are adding their voices to this debate. Republican Sen. John Cornyn of Texas told Axios a few weeks ago, “I think Obamacare has been one of the biggest deceptions on the American people. I mean just look at your health care premiums.” (Premium costs, in reality, have gone down, not up.)

The same report added that Republican Sen. Mike Crapo of Idaho, who’d likely take over the Senate Finance Committee if the GOP retakes control of the chamber, also said he’s open to repeal-and-replace plans.

Remember, the Republicans’ 2017 effort to tear down the ACA was a disaster for the party, which Democrats exploited to help take back the House majority in the 2018 midterm elections. Democrats would love little more than to have this fight again in 2024 — a recent national survey from NBC News found the party with a 23-point advantage over the GOP on health care — which makes it all the more notable when many of the Republicans’ national leaders generously agree to say exactly what Democrats want them to say.

It’s against this backdrop that American consumers are signing up for ACA coverage in record numbers — coverage that would be at great risk if Republicans follow through on their stated goals.