Open Enrollment for Obamacare Has Begun: What to Know About 2025 Health Plans
Friday is the beginning of the annual open enrollment period for the Affordable Care Act health insurance marketplace (also known as “Obamacare”). Most people who get health insurance through either federal or state marketplaces have six weeks to decide on a plan if they want their health care to continue uninterrupted once Jan. 1 rolls around.
Last year, a record-setting 21.3 million people chose a health insurance plan through the ACA’s marketplaces, according to the U.S. Department of Health and Human Services. In total, about 45 million Americans get their health insurance through the ACA marketplace or via expanded Medicaid.
The program has grown in size since enhanced subsidies were introduced in 2021 as a way to help people bear both the financial and health-related costs of the pandemic. They were initially just in place for two years, but 2022’s Inflation Reduction Act pushed the subsidies out until the end of next year.
During open enrollment, people who already have ACA coverage can shop for a new plan or decide to keep the one they have. In most cases, if you don’t take any action, you’ll automatically be re-enrolled in your existing plan for the following year. If your plan is no longer available, you’ll be enrolled in a plan with comparable coverage.
But because even "comparable" plans can have different networks of doctors and prescription drug coverage, it's a good idea to research and make sure that you'll be getting a plan that matches your or your family's specific medical needs, says Louise Norris, a health policy analyst at healthinsurance.org.
Even if you intend to keep the same plan, it's also an opportunity to check that your doctors and medications you take regularly will still be covered by your plan in the new year.
When is open enrollment for 2025 health insurance?
The ACA open enrollment period runs from Friday (Nov. 1) through Jan. 15, 2025 — although if you want to acquire or maintain insurance starting Jan. 1, you need to enroll no later than Dec. 15 (technically, 5 a.m. EST Dec. 16). If you enroll between Dec. 16 and Jan. 15, your health care coverage should begin Feb. 1, after you pay your first premium.
Most state-run exchanges have the same timeline as the federal marketplace, but a few have different deadlines.
In Idaho, for example, open enrollment started Oct. 15 and ends Dec. 15. The deadline in Massachusetts is Jan. 23, and the states of California, New Jersey, New York and Rhode Island, as well as Washington, D.C., let residents enroll through Jan. 31.
But Norris says it’s smart not to wait until the last minute, especially if you anticipate needing help choosing and signing up for a plan. Call center wait times could be long, and if you want assistance from a broker or navigator, their time will be at a premium as Dec. 15 nears.
That deadline is your last chance to make a change in your health insurance for 2025 unless you have a major life event that affects how or where you get your insurance. People can be eligible for a special enrollment period if they or a member of their household has a life event such as marriage, divorce, birth or death, if they move or if they lose health insurance through their employer. The government also makes exceptions for people who fail to enroll on time because of unforeseeable events like natural disasters.
Where do I find the health insurance marketplace?
The federal ACA marketplace is at healthcare.gov. (Experts say it's important to make sure you're on the genuine website, since some brokers use similar-looking web addresses.) In addition, 20 states and Washington, D.C., have their own marketplaces where people can shop for their 2025 health insurance. The state pages are linked from the federal site, as well, so you can start there regardless of where you live.
What else to know about signing up for 2025 marketplace insurance
ACA premiums (aka monthly payments) are rising by 4% nationally, according to health policy and research nonprofit KFF. This doesn't necessarily mean that you'll pay more, though. Plans available in the marketplace come in four coverage levels: bronze, silver, gold and platinum. If the second-cheapest silver plan — what the industry calls the "benchmark" plan — increases in cost, then the subsidies the vast majorities of enrollees receive also rise. That's what's happening in 2025.
This means most Americans shopping for health insurance will be able to find a plan with a premium that fits their budget, says Cynthia Cox, a vice president and director of the ACA program at KFF.
“Most people can still find a premium for less than $10 a month,” she says. "As far as what people pay, it’s probably going to be pretty similar to last year."
More insurers have been entering state markets and expanding their presence in states they already serve, which is also good news for consumers, Cox says. The drawback of having a huge number of plans from which to choose is that it can get complex. Many people enroll through brokers or seek assistance from trained marketplace navigators because pricing out plans are so complicated.
Regulators have implemented some rules around standardization to make comparison-shopping easier. "The idea behind this was that people should have one-stop shopping and be able to compare them in an apples to apples way," Cox says.
Even so, consumers might still have dozens of plans to choose from. If you need help shopping for coverage, you can search for local assistance by zip code. A trained expert called an ACA navigator might be able to help you sort through your plan options, or you can work with a broker or agent. Brokers are paid by the insurance companies, whereas navigators aren't compensated by insurers. Navigators, however, can only help you sort through your options; they can actually recommend one plan over another to you.
You have to calculate your actual premium cost once subsidies or tax credits are factored in, which can be a challenge for people whose income fluctuates from year to year, which can affect the amount of assistance they get. But the premium is just one part of the equation. You also have to compare different plans’ costs for expenses like deductibles, copayments and prescriptions.
If you have a chronic condition or need to see a specialist regularly, you’ll want to make sure that plans you’re evaluating have those providers in-network. If you take medications regularly, you’ll want to see what kind of coverage each plan allows for those prescriptions.
Changes to open enrollment for 2025
KFF says that enrollment might take longer this year for some people who work with brokers, because the federal government has had to respond to a deluge of complaints — 200,000 in the space of six months — from consumers who were unknowingly and unwillingly enrolled or switched into plans by unscrupulous brokers. To thwart these bad actors, regulators implemented new rules: Customers buying their plan through a new broker not already listed on their plan will have to get on a conference call with the broker and a legit ACA marketplace representative.
Residents of Georgia now have a state marketplace, called Georgia Access, where they can compare and sign up for plans. Norris says customer information has been transferred over from the federal platform to the new state one, so Georgia residents already enrolled in a marketplace plan should find switching to be a relatively seamless experience.
"It’s the same insurance companies, same subsidies, same premiums," she says. "Everybody who had coverage, their accounts have been migrated over. It’s not like you have to start all over."
Another change for 2025 is that people who fall under the umbrella of Deferred Action for Childhood Arrivals — aka Dreamers, or undocumented immigrants who were brought to the U.S. as children — are newly eligible to enroll in marketplace coverage and receive subsidies if their income qualifies them.
People who relied on short-term plans for their coverage will need to find alternatives. As of September, people can no longer buy short-term plans with durations of more than four months. For people with short-term policies that will terminate at some point in 2025, they will have to find alternative coverage now.
Unlike losing health insurance through your employer, for instance, termination of a short-term plan will not make you eligible for a special enrollment period.
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