Election Lead-Up: Marketplace and Medicare Advantage Head-to-Head

Health Highlights

In 2024, over 21 million individuals enrolled in health care coverage through the Affordable Care Act (ACA) Marketplace, marking the highest enrollment since the ACA’s enactment. The record-breaking enrollment numbers are driven in part by the enhanced advanced premium tax credits (APTCs) for Marketplace coverage which are set to expire on December 31, 2025, unless Congress intervenes. The fate of the enhanced tax credits may be driven largely by the election outcome. This slide highlights other Marketplace and commercial insurance issues that may be shaped by the composition of the Congress and the next Administration.


As enrollment in the Medicare Advantage (MA) program continues to grow, it has garnered increased attention from policymakers. While both parties largely agree on basic policies to address abusive marketing practices in the MA market, Democrats and Republicans differ in their support for MA. Republicans have generally promoted the MA program, including by increasing flexibilities for plans to provide supplemental benefits. Democrats have sought to highlight perceived limits to MA and costs to the Medicare program.


For more information on the presidential candidate positions (and the likely positions of their party members), visit our health care policy webpage where we highlight their stance on the issues.

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