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Marketplace Enrollment Climbs Nearly Five Million Higher than the Previous Year

A historic 21.3 million people chose the Affordable Care Act (ACA) marketplace coverage during the 2024 open enrollment year. Of the total number of enrollees, about five million people – one in every four — was new to the ACA marketplace, while 16 million people renewed their coverage.

This news comes as four states and Washington, D.C., continue open enrollment through January 31.

“For decades, when it came to federal programs we could depend on to keep Americans covered, three were always top of mind — Medicare, Medicaid, and Social Security, but now it’s crystal clear that we need to add a fourth — the Affordable Care Act,” said Health and Human Services (HHS) Secretary Xavier Becerra. “Once again, a record-breaking number of Americans have signed up for affordable healthcare coverage through the Affordable Care Act’s Marketplace, and now they and their families have the peace of mind that comes with coverage.”

He added that the ACA continues to be a successful, popular, and important federal program to millions of people and their families. As we celebrate the success of this most recent enrollment effort, HHS will double down on the Biden-Harris Administration’s efforts to increase access to quality care and lower costs.

“These historic enrollment numbers are a testament to the need for comprehensive, quality, affordable health insurance, and we must do everything we can to protect and expand access to coverage for all people,” said Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure. “Numbers do not lie: Not only is demand for Marketplace insurance coverage at an all-time high, but the Marketplaces are delivering on the Affordable Care Act’s promise to provide the peace of mind that comes with having health insurance to millions of Americans.”

A major factor this year, in four in five HealthCare.gov customers being able to find healthcare coverage for $10 or less per month for plan year 2024 (after subsidies), was the Inflation Reduction Act (IRA) and the American Rescue Plan, both programs of the Biden-Harris Administration, continuing to keep Marketplace coverage affordable.

Additionally, the administration issued almost $100 million in Navigator Awards, allowing organizations to hire staff trained to help consumers find affordable, comprehensive health coverage. Navigators, as they are known, have been key to helping consumers in every Marketplace state. Locally, it’s these people we’ve seen set up in local retail outlets, there to explain the programs and help people find a program they can afford that meets their healthcare needs.

Open Enrollment Progress

This past year, steps have been taken to expand access to affordable, comprehensive Marketplace coverage for millions of middle-and lower-income families nationwide.

Compared to the Open Enrollment Period last year, nearly 4.2 million more individuals with household incomes less than 250 percent of the federal poverty level (about $75,000 per year for a family of four) enrolled in 2024 coverage. What does this demonstrate? That when coverage is affordable, people sign up.

Marketplace coverage has also been critical for many people transitioning from Medicaid or the Children’s Health Insurance Program (CHIP) as states conduct eligibility renewals, which restarted last year. As of December 31, 2023, CMS data show that 2.4 million plan selections in states that use HealthCare.gov, or approximately 15 percent, were made by individuals who were previously enrolled in Medicaid or CHIP coverage.

The federal 2024 Marketplace Open Enrollment Period ran from November 1, 2023, to January 16, 2024, for states using the HealthCare.gov platform. State-based Marketplace enrollment deadlines vary. State-specific deadlines and other information are available in the State-based Marketplace Open Enrollment Fact Sheet.

Coverage opportunities do remain available even though the annual Open Enrollment Period has ended. Individuals eligible for Medicaid or CHIP may enroll in coverage anytime year-round. For those no longer eligible for Medicaid or CHIP, a special enrollment period is available to enroll in Marketplace coverage.

Additionally, eligible individuals with household incomes less than 150 percent of the federal poverty level (approximately $22,000/year for an individual and $45,000/year for families of four) can enroll in Marketplace coverage anytime through a special enrollment period. Also note that consumers who experience a change of life circumstance — such as marriage, birth, adoption, or loss of qualifying health coverage — may also be eligible for a special enrollment period.

Consumers can visit HealthCare.gov to see if they are eligible to enroll in a low-cost, quality health plan. Because of continuing provisions in the Inflation Reduction Act, CMS expects nine out of 10 customers to be eligible for savings. Visit HealthCare.gov for more information.

Individuals wanting assistance signing up for coverage may go to “Find Local Help” on HealthCare.gov to find a Navigator, Certified Application Counselor, or agent or broker: https://www.healthcare.gov/find-assistance/.

Marketplace Enrollment Snapshot Overview:
Marketplace and Consumer Type         Cumulative 2024 OEP Plan Selections

Total: All Marketplaces                                     21,310,538
New Consumers                                                   5,045,290
Returning Consumers                                       16,265,248

Total: HealthCare.gov Marketplaces              16,363,133

New Consumers                                                   4,226,461
Returning Consumers                                        12,136,672

Total: SBMs*                                                       4,947,405
New Consumers                                                     818,829
Returning Consumers                                         4,128,576

*State-based Marketplace