At least 24.2 million people purchased health insurance on the exchange marketplaces during open enrollment for 2025, the Centers for Medicare and Medicaid Services announced Friday.
That tally surpasses a record set a year ago, as sign-ups for exchange plans accelerated mostly due to the enhanced subsidies enacted in 2021 and extended in 2022. The more generous tax credits are due to expire at the end of the year unless President-elect Donald Trump and the Republican majority in Congress — who have been hostile to the Affordable Care Act of 2010 — renew them.
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“The record-breaking success of this year’s marketplace open enrollment speaks volumes about the Affordable Care Act’s past, present and future serving the American people by connecting our communities to high-quality, person-centered, affordable healthcare coverage,” CMS Administrator Chiquita Brooks-LaSure said in a news release.
The final count of exchange enrollees is likely to be higher than 24.2 million, which is more than double the number for the 2020 plan year, before the enhanced subsidies were available. According to CMS, 3.9 million of those enrollees are new to the exchanges.
Open enrollment ended Wednesday in most states, but a handful of state-based health insurance exchanges are still accepting applications, and some have not submitted complete data to CMS.
In the 28 states where the federal government manages the exchanges and the three states that operate marketplaces but use the federal enrollment platform, 17.1 million people signed up. An additional 7 million enrolled via one of the 20 state exchanges, according to preliminary figures.
If the enhanced subsidies are not extended, 3.8 million more people would be uninsured over the 2026-2034 period, according to an analysis the nonpartisan Congressional Budget Office issued last month. The CBO likewise projects that the benchmark premiums for exchange plans, which determine the value of the subsidies, would increase 7.9% on average over those years.
