Almost 24 million people have signed up for Affordable Care Act plans for 2025, blowing past last year’s record with a full week left in the open enrollment period, regulators announced on Wednesday.
It’s the fourth consecutive year of record enrollment, despite earlier concerns that enrollment was off to a slow start in the fall. Some consumers were worried about how the incoming Trump administration might undermine the decade-old health law and the insurance marketplaces it created, according to a survey published in December.
Similarly, premiums are increasing for ACA plans, by an average of 7%, according to health policy firm KFF.
Still, 23.6 million individuals have signed up for plans so far, surpassing the 21.4 million people who received coverage in the exchanges last year. Of those, 3.2 million people have enrolled in ACA coverage for the first time ever, according to the CMS.
Top healthcare officials in the Biden administration attributed the growth to more generous subsidies for ACA plans that have helped a greater number of people qualify for financial assistance. The subsidies were first enacted in 2021 to help Americans afford insurance during the COVID-19 pandemic, and are currently scheduled to expire at the end of 2025 absent congressional action.
Democrats have already introduced legislation to preserve the tax credits, citing the importance of preserving coverage. Some 4 million people would become uninsured if they’re allowed to lapse.
However, Republicans have levied allegations of increased fraud stemming from the influx of funds, and raised concerns about the burden on the federal budget. The Congressional Budget Office estimates making the subsidies permanent would cost $335 billion over 10 years.
Altogether, it’s an open question whether the subsidies will survive the next administration, though the issue is complicated by the popularity of the ACA and that much of the financial assistance has gone to voters in Republican districts.
The Trump administration could also take a number of actions next year to restrict signups, including stumping for skimpy alternative plans and cutting funding for groups that help consumers shop for ACA coverage.
Open enrollment for ACA plans ends on Jan. 15.
