During this year’s Affordable Care Act (ACA) open enrollment period, premiums are increasing by about 4%, though the vast majority of enrollees won’t have to pay that increase due to enhanced subsidies from the Inflation Reduction Act. Other changes for 2025 include more insurers in many markets, new federal standards aimed at ensuring patients can get timely appointments, and stepped-up efforts to combat fraud. Open enrollment begins on Friday, November 1 (in all states except Idaho), and ends on January 15, 2025 (in most states).
Although health care reform may not be a central issue in this election as in the past, it remains a significant concern for voters. Public opinion about the ACA is favorable and at a high point according to KFF polling, but questions about its future remain.
Without the enhanced subsidies in the Inflation Reduction Act, ACA enrollees in 12 of the states that use HealthCare.gov would see their annual premium payments at least double on average.
ACA Marketplace insurers are proposing a median premium increase of 7% for 2025, similar to the 6% premium increase filed for 2024, according to a KFF analysis of the preliminary rate filings.
In 2024, ACA enrollment hit a new record high, reaching over 21 million people, almost double the 11 million people enrolled in 2020. In 15 states, enrollment more than doubled from 2020 to 2024.