As of June 2025, there were around 1.97 million sign-ups in California. Open enrollment allows U.S. citizens to enroll, switch plans, and get subsidies on various plans under the Affordable Care Act. This statistic displays the number of Affordable Care Act (Obamacare) sign-ups during the 2025 open enrollment period as of June 2025, by U.S. state.

This file includes data for states that are implementing their own Marketplaces, also known as State-Based Marketplaces or SBMs, and states with Marketplaces that are supported by or fully run by the federal government, including those run in partnership with states, also known as the Federally-Facilitated Marketplace or FFM. Includes demographic characteristics, and plan selected (by metal level). Please refer to the full report listed under Resources.

This statistic displays the number of Obamacare sign-ups during the 2020 open enrollment period as a share of the 2019 open enrollment, by U.S. state. In Mississippi, the 2020 OE number of sign-ups was was nearly twelve percent higher than in the 2019 OE round. Open enrollment allows U.S. citizens to enroll, switch plans, and get subsidies on various plans under the Affordable Care Act.

This statistic depicts a projection of the total number of persons in the United States enrolled in health care insurance exchanges under the Affordable Care Act (ACA) from 2015 to 2025. By 2018, the total number of health insurance exchange enrollment is expected to total 25 million nonelderly people.

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov. As of August 2024, CMS is no longer releasing the “HealthCare.gov” metrics. Historical data between July 2023-July 2024 will remain available. The “HealthCare.gov Transitions” metrics, which are the CAA, 2023 required metrics, will continue to be released. Sources: HealthCare.gov application and policy data through May 5, 2024, and T-MSIS Analytic Files (TAF) through March 2024 (TAF version 7.1 with T-MSIS enrollment through the end of March 2024). Data include consumers in HealthCare.gov states where the first unwinding renewal cohort is due on or after the end of reporting month (state identification based on HealthCare.gov policy and application data). State data start being reported in the month when the state's first unwinding renewal cohort is due. April data include Arizona, Arkansas, Florida, Indiana, Iowa, Kansas, Nebraska, New Hampshire, Ohio, Oklahoma, South Dakota, Utah, West Virginia, and Wyoming. May data include the previous states and the following new states: Alaska, Delaware, Georgia, Hawaii, Montana, North Dakota, South Carolina, Texas, and Virginia. June data include the previous states and the following new states: Alabama, Illinois, Louisiana, Michigan, Missouri, Mississippi, North Carolina, Tennessee, and Wisconsin. July data include the previous states and Oregon. All HealthCare.gov states are included in this version of the report. Notes: This table includes Marketplace consumers who: 1) submitted a HealthCare.gov application on or after the start of each state’s first reporting month; and 2) who can be linked to an enrollment record in TAF that shows Medicaid or CHIP enrollment between March 2023 and the latest reporting month. Cumulative counts show the number of unique consumers from the included population who had a Marketplace application submitted or a HealthCare.gov Marketplace policy on or after the start of each state’s first reporting month through the latest reporting month. Net counts show the difference between the cumulative counts through a given reporting month and previous reporting months. The data used to produce the metrics are organized by week. Reporting months start on the first Monday of the month and end on the first Sunday of the next month when the last day of the reporting month is not a Sunday. For example, the April 2023 reporting period extends from Monday, April 3 through Sunday, April 30. Data are preliminary and will be restated over time to reflect consumers most recent HealthCare.gov status. Data may change as states resubmit T-MSIS data or data quality issues are identified. Data do not represent Marketplace consumers who had a confirmed Medicaid/CHIP loss. Future reporting will look at coverage transitions for people who lost Medicaid/CHIP. See the data and methodology documentation for a full description of the data sources, measure definitions, and general data limitations. Data notes: Virginia operated a Federally Facilitated Exchange (FFE) on the HealthCare.gov platform during 2023. In 2024, the state started operating a State Based Marketplace (SBM) platform. This table only includes data on 2023 applications and policies obtained through the HealthCare.gov Marketplace. Due to limited Marketplace activity on the HealthCare.gov platform in December 2023, data from December 2023 onward are excluded. The cumulative count and percentage for Virginia and the HealthCare.gov total reflect Virginia data from April 2023 through November 2023. The report may include negative 'net counts,' which reflect that there were cumulatively fewer counts from one month to the next. Wyoming has negative ‘net counts’ for most of its metrics in March 2024, including 'Marketplace Consumers with Previous M

CMS Enrollment definition - Enables a consumer to verify a veteran's ACA enrollment period

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using HealthCare.gov. Sources: HealthCare.gov application and policy data through October 6, 2024, HealthCare.gov inbound account transfer data through November 7, 2024, and T-MSIS Analytic Files (TAF) through July 2024 (TAF version 7.1). The table includes states that use HealthCare.gov. Notes: This table includes Marketplace consumers who submitted a HealthCare.gov application from March 6, 2023 - October 6, 2024 or who had an inbound account transfer from April 3, 2023 - November 7, 2024, who can be linked to an enrollment record in TAF that shows a last day of Medicaid or CHIP enrollment from March 31, 2023 - July 31, 2024. Beneficiaries with a leaving event may have continuous coverage through another coverage source, including Medicaid or CHIP coverage in another state. However, a beneficiary that lost Medicaid or CHIP coverage and regained coverage in the same state must have a gap of at least 31 days or a full calendar month. This table includes Medicaid or CHIP beneficiaries with full benefits in the month they left Medicaid or CHIP coverage. ‘Account Transfer Consumers Whose Medicaid or CHIP Coverage was Terminated’ are consumers 1) whose full benefit Medicaid or CHIP coverage was terminated and 2) were sent by a state Medicaid or CHIP agency via secure electronic file to the HealthCare.gov Marketplace in a process referred to as an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP. 'Marketplace Consumers Not on Account Transfer Whose Medicaid or CHIP Coverage was Terminated' are consumers 1) who applied at the HealthCare.gov Marketplace and 2) were not sent by a state Medicaid or CHIP agency via an inbound account transfer either 2 months before or 4 months after they left Medicaid or CHIP. Marketplace consumers counts are based on the month Medicaid or CHIP coverage was terminated for a beneficiary. Counts include all recent Marketplace activity. HealthCare.gov data are organized by week. Reporting months start on the first Monday of the month and end on the first Sunday of the next month when the last day of the reporting month is not a Sunday. HealthCare.gov data are through Sunday, October 6. Data are preliminary and will be restated over time to reflect consumers most recent HealthCare.gov status. Data may change as states resubmit T-MSIS data or data quality issues are identified. See the data and methodology documentation for a full description of the data sources, measure definitions, and general data limitations. Data notes: The percentages for the 'Marketplace Consumers Not on Account Transfer whose Medicaid or CHIP Coverage was Terminated' data record group are marked as not available (NA) because the full population of consumers without an account transfer was not available for this report. Virginia operated a Federally Facilitated Exchange (FFE) on the HealthCare.gov platform during 2023. In 2024, the state started operating a State Based Marketplace (SBM) platform. This table only includes data about 2023 applications and policies obtained through the HealthCare.gov Marketplace. Due to limited Marketplace activity on the HealthCare.gov platform in November 2023, data from November 2023 onward are excluded. The cumulative count and percentage for Virginia and the HealthCare.gov total reflect Virginia data from April 2023 through October 2023. APTC: Advance Premium Tax Credit; CHIP: Children's Health Insurance Program; QHP: Qualified Health Plan; NA: Not Available

Under Medicaid expansion, individuals under the age of 65 will qualify for Medicaid if they earn up to 138% of the federal poverty level (FPL). Eligibility limits for children and pregnant women are even lower, meaning their household income is allowed to be higher than 138% of FPL, up to 266% on average for children in expansion states. As of May 1, 2024, 10 states have not adopted the Medicaid expansion. In these states, childless adults who are not disabled or pregnant are not eligible for Medicaid no matter their income (except for Wisconsin). Moreover, a parent with two dependent children may only earn up to as little as 34 percent FPL on average to be eligible for Medicaid. The Medicaid income eligibility within non-expansion states varies greatly. This statistic displays the median Medicaid income eligibility limits for children and adults as a percent of the Federal Poverty Level (FPL) as of May 1, 2024, by state expansion status.

This dataset includes the number of eligible individuals selected and enrolled in a Covered California qualified health plans (QHPs) by rating region and by reporting period. California is comprised of 19 rating regions, and each region has different pricing and health insurance options. Covered California reported data is from the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS) and includes eligible individuals who selected and enrolled in a QHP, and paid their first premium. This dataset is part of public reporting requirements set forth by the California Welfare and Institutions Code 14102.5.

description:

CMS has released new information on Qualified Health Plan selections by county for the 37 states that use the HealthCare.gov platform (including the Federally-facilitated Marketplace, State Partnership Marketplaces and supported State-based Marketplaces) for the Marketplace open enrollment period from November 15, 2014 through February 15, 2015, including additional special enrollment period (SEP) activity reported through February 22, 2015. The data represent the number of unique individuals who have been determined eligible to enroll in a Qualified Health Plan and had selected a Marketplace plan by February 15, 2015 (including SEP activity through February 22).

CMS has released new information on Qualified Health Plan selections by county for the 37 states that use the HealthCare.gov platform (including the Federally-facilitated Marketplace, State Partnership Marketplaces and supported State-based Marketplaces) for the Marketplace open enrollment period from November 15, 2014 through February 15, 2015, including additional special enrollment period (SEP) activity reported through February 22, 2015. The data represent the number of unique individuals who have been determined eligible to enroll in a Qualified Health Plan and had selected a Marketplace plan by February 15, 2015 (including SEP activity through February 22).

As of 2024, roughly 45 million individuals in the U.S. benefited from the Affordable Care Act and were enrolled in some form of ACA-related health insurance. This figure has increased from 12.6 million in 2014, the year ACA took effect. Since then, there has been an increase in the number of people who have become eligible for free or subsidized health care. Individuals can now enroll in ACA Marketplace and be eligible for premium tax credits, they may have become newly-eligible for Medicaid in states that have expanded Medicaid, or were previously eligible but didn't know or were unable to apply. Moreover, some states have introduced the Basic Health Program to provide continuous coverage for low-income individuals whose income fluctuates above and below Medicaid eligibility. This statistic portrays the number of Affordable Care Act-related (ACA) enrollments in the Marketplace, Medicaid, and the Basic Health Program (BHP) in the U.S. from 2014 to 2024.

Context

The Affordable Care Act (ACA) is the name for the comprehensive health care reform law and its amendments which addresses health insurance coverage, health care costs, and preventive care. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 by President Barack Obama and was amended by the Health Care and Education Reconciliation Act on March 30, 2010.

Content

This dataset provides health insurance coverage data for each state and the nation as a whole, including variables such as the uninsured rates before and after Obamacare, estimates of individuals covered by employer and marketplace healthcare plans, and enrollment in Medicare and Medicaid programs.

Acknowledgements

The health insurance coverage data was compiled from the US Department of Health and Human Services and US Census Bureau.

Inspiration

How has the Affordable Care Act changed the rate of citizens with health insurance coverage? Which states observed the greatest decline in their uninsured rate? Did those states expand Medicaid program coverage and/or implement a health insurance marketplace? What do you predict will happen to the nationwide uninsured rate in the next five years?

California has more Medicaid and CHIP enrollees than any other state in the United States. As of April 2023, approximately ** million Americans were enrolled in the Medicaid health insurance programs in California, which accounted for approximately ** percent of the total number of Medicaid enrollees nationwide (**** million). Blow to Medicaid expansion plans California is one of many states that has expanded its Medicaid program under the Affordable Care Act (ACA) to encourage more low-income adults to sign up for health coverage. One of the original aims of the ACA was to limit some of the variations in state Medicaid programs, but the Supreme Court ruled that the expansion should be optional. Governors of the states that did not expand said they were concerned about long-term costs. California is the leading state for Medicaid expenditure, spending approximately **** billion U.S. dollars in FY2020. Health coverage for children The Children’s Health Insurance Program (CHIP) was created as a complement to Medicaid, expanding the reach of government-funded health coverage to more children in low-income families. As of May 2021, over **** million children were enrolled in Medicaid/CHIP programs in California, more than any other state. As of January 2021, the median Medicaid/CHIP eligibility level for children was *** percent of the federal poverty level.

This dataset includes the total number of individuals enrolled in Medi-Cal by eligibility group: Modified Adjusted Gross Income (MAGI), non-MAGI, and Children’s Health Insurance Program (CHIP). The groups are defined by the Centers for Medicare and Medicaid Services (CMS) Performance Indicators (CMSPI) reporting requirements. The Department of Health Care Services (DHCS) submits eligibility and enrollment data regarding Medicaid and CHIP monthly to CMS. The enrollment data represents enrollment totals as of 60 days after the eligibility month (indicated as “Reporting Period” in the dataset). CMS publishes the state total enrollments on the CMSPI website. The total enrollment comprises of individuals who are eligible for full scope Medi-Cal by MAGI – Child, MAGI – Adult, Non-MAGI Child, Non-MAGI Adult, and CHIP eligibility groups. DHCS does not report to CMS the total enrollment in limited scope Medi-Cal or state-only funded programs (indicated as the “Non-CMSPI” in the dataset).

The Medicaid Managed Care Enrollment Report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. The managed care enrollment statistics include enrollees receiving comprehensive benefits and limited benefits and are point-in-time counts. Total Medicaid Enrollees represents an unduplicated count of all beneficiaries in FFS and any type of managed care, including Medicaid-only and Medicare-Medicaid ("dual") enrollees. Total Medicaid enrollment in Any Type of Managed Care represents an unduplicated count of beneficiaries enrolled in any Medicaid managed care program, including comprehensive MCOs, limited benefit MCOs, and PCCMs. The “Medicaid Enrollment in Comprehensive Managed Care” column represents an unduplicated count of Medicaid beneficiaries enrolled in a managed care plan that provides comprehensive benefits (acute, primary care, specialty, and any other), or PACE program. It excludes beneficiaries who are enrolled in a Financial Alignment Demonstration Medicare-Medicaid Plan as their only form of managed care. The “Medicaid Enrollment in Comprehensive MCOs Under ACA Section VIII Expansion” column is a subset of the total reported in column C and includes individuals who are enrolled in comprehensive MCOs and are low-income adults, with or without dependent children, eligible for Medicaid under ACA Section VIII. n/a" indicates that a state or territory was either not able to report data or does not operate a managed care program.

The percentage of Americans covered by the Medicaid public health insurance plan decreased from 18.9 percent in 2021 to around 17.6 percent in 2024. However, the percentage of those insured through Medicaid remains lower than the peak of 19.6 percent in 2015. The expansion of Medicaid The Affordable Care Act (ACA) provided the option for states to expand Medicaid eligibility to people whose income was below a particular threshold. The ACA’s major coverage expansion came into force in 2014, and the number of individuals estimated to be enrolled in Medicaid has since surpassed 75 million. More than 28 million children were enrolled in the program in 2018, representing 38 percent of overall Medicaid enrollment. State Medicaid coverage Initially, the ACA mandated that all state Medicaid programs would have to be extended to provide medical coverage to nearly all low-income groups. However, the Supreme Court rejected that part of the act in 2012, leaving the door open for states to make their own decision on whether they expand their plans. As of September 2021, 39 states plus the District of Columbia have adopted the Medicaid expansion.

Utah consumers by zip code who purchased Affordable Care Act insurance from the HealthCare.gov platform during the 2017 Mid Open Enrollment Period. This includes consumers who interacted with the Spanish version of the site at CuidadodeSalud.gov.

This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.

U.S. states refusing to expand Medicaid often cite high cost as a reason. However, according to this data, the state of Virginia was able to save up to an estimated 85 percent of expected state expansion costs in 2020, just from savings to traditional Medicaid. This is because the federal matching rate is much higher for Medicaid expansion than traditional Medicaid. States pay roughly 25 to 50 percent of the cost for a traditional Medicaid beneficiary, but only 10 percent of the cost for an expansion beneficiary. Virginia is estimated to save 221.4 million U.S. dollars in FY2020, which amounts to roughly 85 percent of its expected state expansion costs in 2020. While there are large variations between states, expansion states may also see reduced spending outside of Medicaid, such as in the areas of uncompensated care and mental health and substance abuse treatment. By reducing the number of uninsured, states can potentially make savings in these other programs that support the uninsured.

There were approximately 28.1 million children enrolled in the Medicaid health care program in 2018, which accounted for nearly 40 percent of the total number of 74 million Medicaid enrollees. Enrollment numbers in each of the four groups have been consistent for several years.

Medicaid expenditure by eligibility group Medicaid is a joint federal and state health care program in the United States. States administer the program, but they must meet some core federal requirements, one of which includes providing health coverage to children in some low-income families. Medicaid expenditure on children was estimated to have totaled 107.2 billion U.S. dollars in 2017, which accounted for nearly 20 percent of the total expenditure during the year – the only enrollment group with a larger share of expenditures was persons with disabilities.

Health insurance options for children The Children’s Health Insurance Program (CHIP) was signed into U.S. law in 1997 and increased health coverage to uninsured children under the age of 19 who were not eligible for Medicaid. States can implement CHIP by expanding Medicaid or operating it as a separate program. More than 9.6 million children were enrolled in the program during 2018, around two million of whom were in the state of California.