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With an Obamacare boom, comes a Medicaid bust

JUANA SUMMERS, HOST:, the federal health insurance marketplace, just had its biggest open enrollment period ever with more than 20 million people signing up. NPR's Selena Simmons-Duffin reports.

SELENA SIMMONS-DUFFIN, BYLINE: In central Florida, Katie Roders Turner has been enrolling folks in health plans on since the beginning. This year...

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KATIE RODERS TURNER: It was incredibly busy.

SIMMONS-DUFFIN: I catch her at her desk at 8:30 at night. The phones have been ringing. She works with 35 staffers in Tampa Bay who walk people through the sign-up process. They're called navigators.

TURNER: For us, we probably have seen about a 25% increase in activity and enrollments across the board.

SIMMONS-DUFFIN: Now that open enrollment is over, she's throwing a potluck for the navigators, and she's already made her dish.

TURNER: A butternut squash quinoa salad with cranberries (laughter).

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SIMMONS-DUFFIN: Enrollment has been going gangbusters on the Obamacare marketplaces across the country. Charles Gaba, a freelance analyst who blogs at, has a guess for this year's final numbers.

CHARLES GABA: When the dust settles at the end of January, when all the numbers are in, I suspect it's going to be around 21.3 million.

SIMMONS-DUFFIN: That's nearly double the number of people enrolled when President Biden took office. Biden used federal funding for navigators and advertising that former President Trump had held back. Congress also passed extra subsidies for Affordable Care Act plans, making some as cheap as $10 a month.

GABA: The enhanced subsidies made the A part of the ACA a reality - you know, affordable.

SIMMONS-DUFFIN: There are still millions of Americans without health insurance. In fact, KFF now estimates 15 million people have lost Medicaid coverage in the past year. It's not yet clear how many of them have moved over to marketplace plans and how many are now uninsured.

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Selena Simmons-Duffin, NPR News.

(SOUNDBITE OF SLUM VILLAGE SONG, "FALL IN LOVE") Transcript provided by NPR, Copyright NPR.

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Selena Simmons-Duffin
Selena Simmons-Duffin reports on health policy for NPR.
Megan Lim
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