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Several factors could drive record-breaking Marketplace enrollment during open enrollment, which starts Nov. 1 offers insights on how Affordable Care Act enrollment may increase due to continued subsidy availability, Medicaid disenrollments, premium stability

Four key factors could result in record-high enrollment in Affordable Care Act (ACA) health plans during the upcoming open enrollment period, which begins Nov. 1, said today.

Growing consumer interest in the ACA Marketplace could be fueled by: relatively stable premiums; the continued availability of subsidies to more buyers; and the disenrollment of millions of people from Medicaid who may seek replacement coverage, according to Louise Norris, a health policy analyst for

“Marketplace enrollment hit a record high in early 2023, and we expect those numbers could increase during this year’s open enrollment period,” Norris said.

In most states, open enrollment for 2024 coverage will start Nov. 1, 2023, and continue through Jan. 15, 2024. Consumers should check their state’s open enrollment deadlines. To have ACA coverage take effect at the start of 2024, consumers will need to enroll by Dec. 15 in most states.

Norris cited key factors that could fuel higher ACA enrollment:

  • Stable premiums: Published premium changes so far show that the average cost of private ACA Marketplace insurance will remain relatively stable or increase only minimally, by single digits, in 2024. But as usual, there’s significant variation from one state to another in terms of how much premiums are changing.
  • ACA subsidy availability: Federal subsidies help reduce the cost of Marketplace health plans for millions of people. Thanks to the American Rescue Plan and Inflation Reduction Act, subsidies will continue to provide financial help to more people. Additionally, some states are offering new or enhanced state-funded subsidies for 2024, including California, Colorado and New Mexico.
  • Medicaid disenrollment: All states have begun disenrolling people who had Medicaid but lost eligibility when the public health emergency ended. Some people who lost Medicaid coverage will be shopping on the ACA Marketplace for replacement insurance. The federal government estimates about 2.6 million people who lose Medicaid will qualify for financial help to lower the cost of a Marketplace plan.
  • Eligibility for DACA recipients: Also potentially fueling enrollment growth is the Biden administration’s proposed rule change that would allow DACA (Deferred Action for Childhood Arrivals) recipients to enroll in Marketplace plans starting Nov. 1. An estimated 580,000 DACA recipients would be newly eligible for Marketplace plans, Basic Health Plans, and Medicaid/CHIP if and when this rule is implemented.

New insurers enter Marketplaces

The individual/family insurance market has become more stable than it was several years ago, as evidenced by single-digit average premium increases (with variation from one state to another) and very few insurer exits.

Also, in some states, new insurers are joining the Marketplace for 2024, including Indiana, Maryland, Colorado, California, Nevada, Oklahoma, New Mexico, Utah, and Delaware.

“We still see a trend toward increased insurer participation in the exchanges, and this year is no exception,” Norris said. “But even where insurers remain the same, the available plans and which benefits are included could differ. That’s why it’s important to compare your available plan options and not just let your existing plan auto-renew.”

Thousands of consumers were impacted earlier this year when Friday Health Plans shut down business in five states: Colorado, Georgia, North Carolina, Nevada and Oklahoma. Additionally, Oscar Health is leaving the exchange in California at the end of 2023, so their plans will not be available in California during the open enrollment period for 2024 coverage.

“If your health insurer is leaving the market, it’s especially important to compare the available options for 2024 and pick the replacement plan that best fits your needs,” Norris said. “And if you already switched to a new plan, this open enrollment period is equally important for you. Even if your new plan just took effect recently, it will renew on Jan. 1 – just like all other individual/family plans – and that means the rates and benefits are likely to change. Take some time to review your coverage options now.”

Find more detailed information about open enrollment in’s ACA Open Enrollment 2024 Guide. provides online resources for consumers about individual and family health insurance. has been providing consumer information about health insurance and health reform for over 25 years.


Amy Fletcher Faircloth [email protected]

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