Record Michiganders seek health insurance through ACA marketplace in 2023


A record number of Michigan residents have signed up for health insurance through the Affordable Care Act marketplace for 2023.

On Thursday, January 26, state officials announced a total of 322,273 enrollments in Michigan. This was an increase of 7% compared to last year. Sign-ups have risen for three consecutive years after a downward trend from 2017 to 2021.

This year’s increase mirrored national numbers. A record 6.3 million Americans signed up for coverage through the federal program. Many of them are seeing reduced prices thanks to the Inflation Reduction Act.

The law, passed by Congress in 2022, capped co-payments for insulin at $35 per month for Medicare recipients, made covered vaccines available for free to Medicare Part D recipients, and reduced premiums for millions of families covered by the Affordable Care Act. Act market is insured.

“Hundreds of thousands of Michiganders have chosen a high-quality, affordable marketplace health insurance plan and that’s a huge win for the health of this state,” said Anita Fox, director of the Michigan Department of Insurance and Financial Services.

“We know that having comprehensive health insurance leads to healthier families and a healthier, more productive Michigan because it provides access to care for illnesses and injuries, but also to preventive care such as childhood vaccinations and cancer screenings.”

More families became eligible for subsidies this year after the federal government instituted a previous policy nicknamed the “family bug.” In the past, eligibility for financial assistance through the marketplace was based on whether an individual had access to affordable employer-sponsored insurance. But whether the plan was affordable was based only on coverage for the employees, not their families.

The recent rule change bases the affordability determination on the cost of coverage for the employee plus family members. Eligible families will be those paying 9.12% or more of their household income for the employer-sponsored plan.

“This means more than 55,000 additional Michiganders now have insurance and get preventive care and childhood vaccines without out-of-pocket costs,” said Joseph Palm, regional director for the US Department of Health and Human Services.

In 2022, the U.S. uninsured rate was around 8%, which Fox called an all-time low. The latest data she saw for Michigan’s rate was about 6%.

The deadline to enroll in coverage through the marketplace has passed, but some residents will qualify for a special enrollment period if they’ve experienced a qualifying life event, such as a birth, job loss or divorce.

Fox said she doesn’t have specific data on what may have contributed to the increase, but it’s likely a combination of factors, including trends in employer-sponsored coverage, shifts in employment, subsidy eligibility and moves to get off Medicaid , while still comprehensive. plans.

“At our department, we’ve seen a huge influx of people who wanted to be insurance agents during the pandemic, which maybe gives them more control over their income, a little more self-employment, and those people can lose employer-sponsored health coverage and go to a plan, ” she said.

Over the past two decades, there has been a decline in businesses offering health care benefits, according to annual survey data from the Kaiser Family Foundation. In 2022, an estimated 51% of businesses of all sizes offered health insurance to at least some of its workers. That number was 59% in 2021 and 66% in 1999.

Almost all large companies – those with 200 or more workers – offer health benefits to their workers. Smaller firms are less likely to provide such benefits due to budget constraints.

An estimated 67% of businesses with 10 to 199 workers offered health benefits last year, compared to 72% in 2021 and 81% in 1999. Similarly, firms with three to nine workers dropped from 49% in 2021 to 39% in 2022. , according to the results of the Kaiser Foundation survey.

Over the past decade, the trend has been for many businesses to reduce benefits or shift more cost-sharing onto the employee, via higher deductibles and co-payments, to offset rising health care costs, said Bret Jackson, president and chief executive officer of the Economic Alliance for Michigan, explained. a non-profit organization made up of businesses and unions working to grow Michigan’s economy.

But a tighter labor market has forced some more competitive industries to pivot and expand available benefits to attract and retain workers.

“It’s not that they’re not concerned about cost,” Jackson said. “You can’t get people to work in grocery stores, in gas stations. I think overall the trend is going to be to do things to incentivize people to work, not to discourage people like removing benefits.”

The Kaiser Foundation 2022 survey of more than 2,100 employers, published in December in the journal Health Affairs, showed little change in annual family premiums for employer-sponsored health insurance in 2022 compared to the previous year. The average annual increase in family premiums was 1%, the lowest year-on-year increase in decades.

But with a recent rise in inflation, larger increases in annual premiums are likely on the horizon for 2023, Kaiser Foundation President and CEO Drew Altman noted in a press release.

For Jackson, that’s already a reality at the Economic Alliance for Michigan. The company’s benefit plan for 2023 is expected to cost 13.8% more than in 2022.

“Small businesses are just being killed by health care costs,” Jackson said. “We need Congress, we need our state legislature to really attack what’s driving health care costs and it’s hospitals, it’s drugs, it’s (pharmacy benefit managers), it’s private equity.”

Since 2012, inflation has increased by 25%, while wages have risen by about 38% and the average premium for family health care coverage has increased by about 43%, according to the Kaiser Foundation survey.

For more information about obtaining health insurance, visit, or call 877-999-6442 between 8:00 a.m. and 5:00 p.m. weekdays.

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