After Another Record Year for ACA Enrollment, What’s Next for the Marketplaces?

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Today, January 15, is the last day to sign up for Marketplace coverage in most states. Preliminary signup numbers reported by CMS indicate record-breaking enrollment in the ACA Marketplaces for the fourth year in a row. As of January 4, 2025, at least 23.6 million people had signed up for Marketplace coverage, already surpassing the 21.4 million enrollees signed up during the 2024 open enrollment, which itself was a record high. This 2025 figure is likely to increase when final signup data are available after the close of open enrollment in all states.

Why has the Marketplace grown so much in recent years?

This record-breaking growth is largely due to enhanced subsidies first introduced in 2021. The enhanced subsidies expand the amount of financial assistance offered on the ACA Marketplace and who qualifies for this help. As coverage became more affordable (or free, in some cases), Marketplace signups increased. Marketplace enrollment has more than doubled since 2020, before the enhanced subsidies went into effect.

While enrollment numbers for some states are not yet up-to-date so far in 2025, ACA Marketplace enrollment has more than tripled since 2020 in at least 6 states: Texas, Mississippi, Georgia, Louisiana, West Virginia, and Tennessee. All of these states were won by President Trump.

What’s in store for the future?

The enhanced subsidies that have driven so much growth in ACA enrollment are set to expire at the end of this year. If Congress does not renew the subsidies, enrollee premium payments are expected to rise by more than 75% and millions are expected to drop coverage. While Republicans in Congress are looking for ways to lower federal spending and have been overwhelmingly opposed to the ACA from the start, the fact that an increasing number of people in red states are getting coverage through the ACA may give them pause about letting the enhanced subsidies expire altogether.