Americans signed up for Affordable Care Act Marketplace coverage at record numbers during the enrollment period that ended on January 15. At least 14.2 million plan selections were reported, according to Insurancenet.com. This reflects a combined total from the 33 states that use the healthcare.gov platform and the 18 state-based Marketplaces.

"The expanded premium tax credits implemented in the American Rescue Plan Act of 2021 remain in place, boosting affordability and capping premiums as a share of income," said Katherine Hempstead, senior policy advisor for the Robert Wood Johnson Foundation. "While it is not yet clear how much new enrollment will result from the open enrollment period itself vs. the prior special enrollment period, the year-over-year increase in membership is nevertheless impressive, currently estimated at approximately 20%."

The number of county-level exchange offerings has increased each year since 2019. Initially, issuer participation increased while enrollment was essentially flat. This year featured robust growth in enrollment but some moderation in issuer participation trends.