If you’re looking to buy a health plan through the Affordable Care Act, open enrollment ends Tuesday on the federal marketplace and in most states.

Already, it’s been a record year for signups, according to a new analysis from the health policy nonprofit KFF. More than 20 million people have signed up for ACA coverage on the marketplaces so far.

“This is almost double the number of people who were signed up just a few years ago,” said Cynthia Cox at KFF.

In 2020, about 11 million people enrolled, she said. That number has grown steadily since the pandemic hit — this year it’s shot up by more than 4 million.

One big reason for the increase? 

“During the pandemic, states were prohibited from disenrolling people from Medicaid. That ended in 2023,” Cox said.

And when millions of people lost Medicaid coverage, many found their way to the marketplaces to buy it.

ACA plans have also become a lot more affordable in the last few years, thanks to more generous pandemic-era subsidies that are still in place, said Rice University health economics professor Vivian Ho.

“There’s more knowledge filtering out about that as we go month by month. You know, sort of people talk with other people and say, ‘Oh, have another look,'” she said.

And when people do look, she said, many find they’re eligible for free or low-cost coverage.

“The [Joe] Biden administration has also increased the number of navigators that help people who’ve never bought insurance,” Ho said. Which has also helped get more people signed up.

The numbers are encouraging, she added, but they aren’t enough.

“What I’m waiting to see is, after this is all over, do we actually have a net increase in the percentage of Americans insured,” Ho said.

Or will this increase in ACA coverage be offset by all the people who lost insurance through Medicaid?