Record number of Americans enroll in ACA

More than 23 million Americans, a record number, signed up for Affordable Care Act (ACA) Marketplace coverage for 2025 before the Jan. 15 deadline.

It represents an almost 100% increase in enrollment since President Joe Biden took office. Over 45 million Americans are covered through the ACA's Marketplace and Medicaid expansion, marking an all-time high in health insurance coverage in U.S. history.

"When I took office, I made a promise to the American people that I would bring down the cost of health care and prescription drugs, make signing up for coverage easier, and strengthen the Affordable Care Act, Medicare, and Medicaid," Biden stated in a release.

I'm proud that my administration delivered—even as Republican elected officials stood in the way. I urge Congress to double down on the progress we have made by extending the ACA premium tax credit this year."

Over the past four years, the administration implemented initiatives contributing to record-breaking enrollment and reduced healthcare costs. Key measures included enhancing ACA premium tax credits, which saved consumers an average of $800 annually on premiums, and simplifying enrollment processes, particularly for underserved and rural communities.

Medicaid expansion in four additional states provided coverage for over one million people while eliminating bureaucratic barriers ensured millions could apply for or renew coverage seamlessly.

The administration also helped lower prescription drug costs, with the Medicare Drug Price Negotiation program achieving prices 38% to 79% lower than U.S. list prices for the first ten negotiated drugs.

Medicare beneficiaries benefited from a $2,000 annual cap on out-of-pocket costs and a $35 monthly cap on insulin. The White House said those initiatives put billions of dollars back into the pockets of seniors and individuals with disabilities.

"Nearly 24 million people, a record number, have signed up for Marketplace coverage — and the Open Enrollment Period is not over yet. The Affordable Care Act health insurance marketplace and reforms have proven to be successful and critically important for millions of Americans and their families," said Health and Human Services (HHS) Secretary Xavier Becerra.

"Every American should have access to quality, affordable health care — and thanks to the ACA, they do. The Affordable Care Act now stands along with Medicare, Medicaid, and Social Security as one of the most consequential social programs in the history of our nation."

Despite these successes, the ACA faces an uncertain future. President-elect Donald Trump and Republican lawmakers, who will control the House and Senate, have expressed intentions to overhaul the law.

Officials noted that enhanced premium tax credits are set to expire without Congressional action. If that happens, premiums could skyrocket. For example, a single parent earning $50,000 annually could see their premiums increase by $1,600, while a retired couple earning $85,000 could face an $18,000 increase. Experts estimate that between three and five million Americans could lose health insurance entirely.

"If Republicans in Congress take away the enhanced premium tax credits, premiums will skyrocket, and millions of Americans could lose coverage," he said. "We cannot afford to let this progress slip away."

The White House noted that the ACA's impact extends beyond Marketplace coverage. Today, Medicaid covers approximately 80 million Americans, with the administration driving initiatives to simplify enrollment and expand postpartum coverage for hundreds of thousands of new mothers.

"We can't lose sight of what's behind our tremendous, record-setting progress: Millions of individuals and families who now have a critical connection to the lifeline of health care coverage," said CMS Administrator Chiquita Brooks-LaSure.

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