Both Affordable Care Act Plans and Nevada Health Link Reach Record Enrollment in 2025

Enrollment in Affordable Care Act qualified health plans reached 24.3 million people in 2025. That figure represented about 7.2% of the U.S. population and marked the highest level since the marketplaces began operations. The record enrollment occurred while enhanced federal premium subsidies remained in effect through the end of 2025.

Enrollment rates vary widely by state. Florida reported the highest share at 20.3% of its population, while New York had the lowest at 1.1%. New York’s low marketplace enrollment stems largely from its own generous state-sponsored coverage options, particularly the Essential Plan, which provides zero-premium coverage to many lower-income residents.

Nevada operates its own state-based marketplace, Nevada Health Link. The state set a record in 2025 with more than 110,000 enrollees, an 11.5% increase from the prior year, representing roughly 3.4% of the state’s population.

Following the expiration of the enhanced federal subsidies at the end of 2025, Nevada enrollment for 2026 coverage fell to 104,300. That marks a 5.8% decline from 2025, though state officials described the total as relatively stable despite higher premiums.

The expiration of the enhanced Affordable Care Act subsidies was a contentious issue during the 2025 government funding debates and contributed to the partial government shutdown negotiations in the Senate.