2025 ACA open enrollment breaks records with time to spare

The Affordable Care Act marketplace broke previous enrollment records by reaching 23.6 million enrollees during ACA open enrollment for 2025, according to a CMS press release. Open enrollment is still ongoing until Jan. 15, 2025.

Almost 3.2 million new consumers had enrolled in 2025 ACA marketplace plans as of Jan. 4, 2025. Over 2.32 million new consumers picked plans on the federal ACA marketplace and the remaining nearly 849,000 new consumers selected state-based marketplace plans.

So far, the states with the highest total enrollment are Florida, Texas, California, Georgia and North Carolina. These states have a high demand for healthcare coverage. Three of the top five states with the highest ACA enrollment in 2025 have not expanded their Medicaid programs. Additionally, Texas, Florida and Georgia were among the top five states with the highest uninsurance rates, according to U.S. Census Bureau data.

The total enrollment number includes 20.4 million people who were already enrolled in the marketplace for 2024. Over 14.3 million people returned through the HealthCare.gov marketplace while another 6.0 million were returning state-based marketplace enrollees.

Additionally, some were automatically reenrolled while others selected 2025 plans. All 20 state-based marketplaces report automatic reenrollments, as revealed in a national snapshot. Of the 6.04 million state-based marketplace plan selections among returning consumers, more than 4.68 million were the result of automatic reenrollment.

"To the millions more who may still need coverage: Don't delay. Help is still available, including tax credits that have made coverage more accessible by reducing the barrier posed by high costs," CMS Administrator Chiquita Brooks-LaSure said in the press release.

CMS noted that around 80% of consumers (four out of five) on the federal ACA marketplace have access to at least one plan with a premium at or less than $10 per month. Policies from the Inflation Reduction Act of 2022 continue to increase access to premium tax credits that reduce consumers' monthly premiums.

The enrollment rates are historic. Due in part to the accelerated uptake of ACA marketplace plans, Americans are experiencing more pervasive health insurance coverage than at any other point in U.S. history, according to a White House press release in response to the CMS data. In the last four years, the number of Americans with healthcare coverage has almost doubled.

In response to this data, President Joe Biden pushed Congress to extend the ACA premium tax credits again.

"I urge Congress to double down on the progress we have made and ensure Americans have access to quality, affordable health care by extending the ACA premium tax credit this year," the president said in the White House press release.

The Inflation Reduction Act's premium tax credit extension is set to expire on Jan. 1, 2026.

Kelsey Waddill is a managing editor of Healthcare Payers and multimedia manager at Xtelligent Healthcare. She has covered health insurance news since 2019.