How Individual Market Enrollment Changed with the Enhanced Premium Tax Credits

Affordable Care Act (ACA) Marketplace enrollment increased following the enactment of enhanced premium tax credits in 2021, as more individuals became eligible for subsidies. In 2025, individual market enrollment reached a record high of 25.2 million people. However, it is not yet known how many ACA enrollees effectuated coverage, so the size of the on- and off-exchange market remains uncertain. In 2024, the effectuation rate was 96.9%. If that rate holds steady, approximately 23.6 million people would have enrolled in coverage through the exchanges in 2025, with an estimated 1.6 million enrolled off-exchange. (Note: The aforementioned effectuation rate and estimates of on and off-exchange enrollment for 2025 were corrected on June 18, 2025).