For 12 years now, one of the traditions of ACA Signups has been The Graph: A line graph tracking enrollment in ACA policies over the course of each Open Enrollment Period.

The original Graph from 2013-2014 looked quite different from more recent years, partly because I was attempting to track Medicaid/CHIP enrollment and other coverage categories at the same time, and partly because, frankly, I didn't really know what I was doing at the time.

Over the next few years I modified & improved both my methodology as well as the format, culminating in last year's 2025 Open Enrollment Period Graph, which featured the highest enrollment figures in the ACA's history: ~24.3 million Qualified Health Plan (QHP) enrollees, plus another ~1.8 million Basic Health Plan (BHP) enrollees in Minnesota, New York & Oregon specifically, for a grand total of just a hair over 26 million people.

For the 2026 Open Enrollment Period, however, actual hard enrollment data has been, shall we say, difficult to come by so far.

I don't know if this is new or not, but it turns out that Covered California--the largest state-based ACA exchange in the country--has an Open Enrollment Dashboard after all!

This means that in addition to two small states regularly reporting Open Enrollment data (Maine and New Mexico), the largest one is as well!

Here's what Covered CA is reporting as of November 29th:

• New enrollments: 45,023
• Active renewals: 365,879
• Passive/Autorenewals: 1,412,526
• Total: 1,823,428

As I've noted in both my Maine and New Mexico updates, while I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).4,

via MNsure, Minnesota's ACA exchange (email only for now):

Minnesota residents affected by the end of Strategic Limited Partners coverage can enroll in new health insurance through MNsure

ST. PAUL, Minn.—MNsure is opening a limited special enrollment period (SEP) for Minnesota residents who purchased insurance through Strategic Limited Partners offsite of the MNsure website. The SEP follows enforcement action by the Minnesota Department of Commerce.

Commerce found that Strategic Limited Partners, an unlicensed company, sold unauthorized and deceptive health coverage to Minnesotans through misleading ads. Under a consent order, Strategic Limited Partners must cease operations by December 31, 2025, notify customers of its exit, repay outstanding claims, and pay a civil penalty.

To protect affected consumers, MNsure is offering this limited SEP:

Back in October, I noted that the New Mexico Insurance Superintendent--in the midst of dropping some very bad news about the upcoming 36% average premium increases for New Mexico ACA policies--included an extremely important caveat:

While it appears that Congress will allow enhanced federal Premium Tax Credits to expire, New Mexico’s Health Care Affordability Fund (HCAF) will cover the loss of the enhanced premium tax credits for households with income under 400% of the Federal Poverty Level (or $128,600 for a family of four), providing up to $68 million in premium relief for working families who enroll in coverage through BeWell in 2026. Federal and state premium assistance will continue to reduce the impact of the rate increases.

CoverME, Maine's ACA exchange, is the second state after New Mexico to publish official 2026 Open Enrollment data:

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2026. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin coverage. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2026 is December 15, 2025. Consumers who select a plan between December 16, 2025 and January 15, 2026 will have coverage beginning February 1, 2026. 

BeWell NM, New Mexico's ACA exchange, is the only state marketplace with ongoing daily enrollment data reports:

New Mexico Open Enrollment 2026 - Enrollment Summary

Last Refreshed On: December 2, 2025

Officially, they're reporting 75,926 Qualified Health Plan (QHP) enrollments already, which is actually 8% higher than the 70,373 which they ended with during the 2025 Open Enrollment Period (OEP) last January.

HOWEVER...and this is a major caveat...that 75,926 includes all current enrollees being auto-renewed for 2026, which doesn't really count for my purposes. Most state exchanges used to hold off on lumping in the auto-renewals until after the initial December deadline, only reporting current enrollees who actively re-enroll along with new enrollees.

When I look at it that way, I get:

Earlier this afternoon I joined cancer survivor and healthcare reform advocate Laura Packard on her CareTalk podcast to discuss the upcoming expiration of the enhanced ACA tax credits and the Trump Regime's confusing, will-they-or-won't-they non-proposal to maybe, possibly extend them...with a bunch of major caveats attached. Tune in!

For nearly a year now I've been shouting from the rooftops about the eye-popping net premium hikes which millions of ACA enrollees are going to see starting one month from today, assuming the enhanced Advanced Premium Tax Credits (eAPTC) which have been in place for the past five years are allowed to expire on New Year's Eve.

I've put together 51 bar graphs showing examples of what these net premium increases will look like for various households at different income levels in every state. Since there's so many variables from state to state including different Rating Areas, different levels of carrier participation, different provider networks and different benchmark Silver plans from county to county (and even from zip code to zip code), I decided to use the capital city of each state as my rule of thumb.

For the households, I went with four case studies: A single 50-yr old adult w/no dependents; a 30-yr old single parent with one child; a "nuclear family" (40-yr old couple with two kids age 15 & 12); and a pre-retiree couple (64 yrs old, just shy of Medicare eligibility age).

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

August 2025 Key Findings

Medicaid and CHIP Enrollment

• In August 2025, 77.3 million individuals were enrolled in Medicaid and CHIP.
• 70.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
• 40.4 million adults were enrolled in Medicaid, and there were 36.9 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding July and August 2025 to the data archive.

Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.

In any event, according to the latest report, as of August 2025:

• Total Medicare beneficiaries are up to 69.3 million (up ~86K month over month)
• Traditional/FFM Medicare beneficiaries are at 33.79 million (down ~31K m/m)
• Medicare Advantage beneficiaries reached 35.49 million (up ~55K m/m)
• 11.73 million Medicare enrollees (around 16.9% of the total) were "Dual Eligibles"...that is, enrolled in both Medicare and Medicaid.

The only number which seems odd is the 375K drop in Dual Eligibles...I'm not sure what to make of that.