Health Insurance Exchanges: Sources for Enrollment Data

Health Insurance Exchanges: Sources for Enrollment Data

Health Insurance Exchanges: Sources for Enrollment Data

September 16, 2026 (IN12736)

Under the Patient Protection and Affordable Care Act (P.L. 111-148, as amended), exchanges (sometimes called marketplaces) have been established in every state. Generally, states have two types of exchanges—individual exchanges and small business health options program (SHOP) exchanges—in which consumers and small businesses, respectively, can shop for private health insurance coverage.

Different types of exchange enrollment data are released throughout the year by the Centers for Medicare and Medicaid Services (CMS). CMS data vary in whether they include all states or just the states that use the federal HealthCare.gov platform.

This Insight provides links to some of the most frequently requested health insurance exchange data. It is not a comprehensive resource but includes an overview of the types of federal data available for the health insurance exchanges. For more information on the health insurance exchanges, including a discussion of enrollment data, see CRS Report R44065, Health Insurance Exchanges and Qualified Health Plans: Overview and Policy Updates.

What is the difference between the types of enrollment statistics?

Pre-effectuated enrollment data reflect individuals who have selected a plan but might not necessarily have paid their first premium. Pre-effectuated data are often released during or soon after the open enrollment period (OEP).

Effectuated enrollment data reflect individuals who have selected a plan and have submitted the first premium payment. Effectuated data is typically released several months after the OEP. This data is available through data.cms.gov, and some older datasets are archived on the CMS Archive page.

Where can I find health insurance exchange data?

The following table provides links to some of the federal health insurance exchange datasets available.

Table 1. Types of Individual Health Insurance Exchange Data from Centers for Medicare and Medicaid Services (CMS)

Data | Type of Enrollment Data | Where to Find It | What It Includes
Current plan year enrollment | Pre-effectuated | CMS Newsroom | National and state data snapshots are typically released during and soon after the annual open enrollment period (OEP)—that is, around November-January.

Pre-effectuated

2026 Marketplace Open Enrollment Period Public Use Files

Final national, state, and county data on exchange activity for the full OEP, including health insurance applications, Qualified Health Plan (QHP) selections, and stand-alone dental plan (SADP) selections. Includes demographic characteristics of consumers who selected plans, and data on enrollment with advance premium tax credits (APTC) and cost-sharing reductions (CSR).

Certain data are available only for HealthCare.gov states.

| Pre-effectuated | 2026 Open Enrollment Report | Summary of national and select state data on exchange enrollment with financial assistance (APTC and CSR).
| Effectuated | Health Insurance Exchanges Monthly Effectuated Enrollmenta | Monthly national, and state effectuated enrollment counts.
Prior plan years enrollment | Pre-effectuated | Marketplace Open Enrollment Period Public Use Files | National and state data on exchange enrollment with financial assistance (APTC and CSR) from 2017 onward.b Certain data are available only for HealthCare.gov states.
| Effectuated | Health Insurance Exchanges Annual Effectuated Enrollmentc | Annual national and state effectuated enrollment data since 2016 including APTC and CSR enrollment and average premium with APTC.
| Effectuated | Effectuated Enrollment, February of each year, 2017-2025 | National and state effectuated enrollment data for the total number of individuals with active policies at any point in the month of February for years 2017-2025.
Congressional district (CD)d | Pre-effectuated | Open enrollment period plan selections, 2024 | Plan selections, including APTC, by CD. Data limited to HealthCare.gov states.
| Pre-effectuated | ARP/IRA Savings for HC.gov OE [Open Enrollment] 2024 Plan Selections Made by Consumers Who Elected to Receive APTC; and ARP/IRA Savings for All HC.gov OE 2024 Plan Selections (XLSX)e | Plan selections and average 2024 monthly net premium and average 2024 monthly APTC, by CD. Data limited to Healthcare.gov states.
County | Pre-effectuated | Marketplace Open Enrollment Period Public Use Files | Data vary by year. Generally, includes total plan selections, financial assistance, and demographics. Certain data elements are available only for counties in HealthCare.gov states.
| Pre-effectuated | ARP/IRA Savings for HC.gov OE [Open Enrollment] 2024 Plan Selections Made by Consumers Who Elected to Receive APTC; and ARP/IRA Savings for All HC.gov OE 2024 Plan Selections (XLSX)e | Plan selections, average net premiums, and average APTC, both with and without the ARP/IRA enhancements.

Source: Compiled by CRS from CMS.gov and Data.CMS.gov.

Notes:

a. Monthly effectuated enrollment data: scroll down for the Data Dictionary (defines column headings) and methodology. Data may be filtered by time (e.g., month), by geography (e.g., state, total [national]), and/or by exchange platform (e.g., state-based exchanges, HealthCare.gov [states using the federal exchange platform]).

b. Choose year from left navigation bar, then scroll to "OEP State-Level Public Use File" under downloads.

c. Annual effectuated enrollment data: scroll down for resources including frequently asked questions, Data Dictionary (defines column headings), and methodology. Data may be filtered by time (e.g., year), by geography (e.g., state, total [national]), and/or by exchange platform (e.g., state-based exchanges, HealthCare.gov).

d. Reflects 118th Congress CD boundaries. Data for 2024 are the most recent CD data that CRS found on the CMS website.

e. The FY2022 reconciliation act, commonly referred to as the Inflation Reduction Act of 2022 (IRA, P.L. 117-169), extended premium tax credit enhancements through tax year 2025. The American Rescue Plan Act of 2021 (ARP, P.L. 117-2 ) temporarily expanded eligibility for, and the amount of, the APTCs for certain individuals. This spreadsheet was linked from CMS, Other Resources.

Are there data on SHOP exchange enrollment?

Data on SHOP exchange enrollment are not regularly released. However, a recent resource includes certain enrollment data for small group markets both on and off the SHOP exchanges:

2019-2024 Enrollees Without Claims by State Market Metal Level (XLSX) (CMS, linked from Other Resources) includes small group market enrollment data, nationwide and for all states. In general, the small group data combine on- and off-exchange enrollment, but some data specific to the SHOP exchanges are available. For SHOP data, filter the "silver variant" column to "on". See methodology notes within the file for more information, including regarding suppressed data.

SHOP exchange enrollment is discussed further in CRS Report R44065, Health Insurance Exchanges and Qualified Health Plans: Overview and Policy Updates.