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. 2025 Oct 13;13:1643109. doi: 10.3389/fpubh.2025.1643109

Table 3.

Number of insurers vs. enrollment.

Year Nationwide # of insurers On-marketplace Off-marketplace
Median # of insurers at state-level National enrollment (in millions) Median # of insurers at state-level National enrollment (in millions)
2014 100 4 8 Not available Not available
2015 184 5 11.7 6 9.6
2016 170 4 12.7 5 8.1
2017 164 3 12.2 4 6.4
2018 137 2 11.8 2 4.2
2019 132 3 11.4 2 3.6
2020 138 3 11.4 3 3.4
2021 146 5 12 3 3.6
2022 153 5 14.5 3 3.2
2023 159 5 16.4 3 2.5
2024 155 6 21.4 2 2.5

Data on numbers of insurers are derived from the 2014–2024 HIX Compare. Enrollment data (both on- and off-marketplace) are from KFF (https://www.kff.org/private-insurance/issue-brief/as-aca-marketplace-enrollment-reaches-record-high-fewer-are-buying-individual-market-coverage-elsewhere/). The 2025 off-marketplace enrollment of 2.5 million was KFF’s estimate. HIX Compare does not report any off-marketplace plans in 2014; hence there is no information on the median number of off-marketplace insurers for that year.