1.3 million fewer people enrolled in the ACA marketplace this year compared to last year

After Donald Trump and Republicans refused to extend the enhanced Affordable Care Act premium tax credits at the end of last year, health care premiums skyrocketed by an average of 114% — resulting in monthly costs often higher than mortgages. As a result, many working families have been forced to purchase the cheapest monthly plans with the highest deductibles. New data show that 1.3 million fewer people enrolled in the ACA marketplace during the 2025 open enrollment period compared to 2024, and the number of sign-ups is only expected to worsen as premiums continue to rise. Nearly 40% of new enrollees selected plans with higher deductibles, and health experts warn that this broad move could lead patients to delay or forgo care altogether, and potentially take on medical debt despite having health insurance. 

In a new poll, most Americans say that their top concern is the cost of health care, as a majority of adults say they expect their health care costs to become less affordable in the next year, and more than 1-in-3 adults say they are “very worried” about health care bills. 

In response, DNC Rapid Response Director Kendall Witmer released the following statement: 

“Donald Trump and Republicans have been clear that they have no qualms, allowing millions of Americans to choose between going to the doctor, putting food on the table, or keeping a roof over their heads. First, they made the largest cuts to Medicaid in history, putting hundreds of rural hospitals at risk of shuttering. Then, they allowed the ACA tax credits to expire, raising premiums and making health care unaffordable for millions of working Americans. Now, Americans are being forced to choose plans with higher deductibles or drop their insurance altogether. Democrats have put forward common-sense solutions to address this crisis and lower costs, but time and again, Trump and Republicans have shot them down and have chosen tax cuts for billionaires over everyday Americans.” 

Earlier this month, Trump released his health care “plan,” which includes limited details and leaves Americans to figure out their own health insurance coverage, saying, “You’ll make a great deal.” Experts have warned that Trump’s plan does not take meaningful action to lower health care costs, and the White House refused to commit to protecting coverage for individuals with pre-existing conditions. Trump’s own administration has even questioned whether Trump’s plan to send money directly to Americans for health care was “sustainable.” It’s no surprise that nearly 70% of Americans disapprove of Trump’s handling of health care.