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The annual individual major medical insurance open enrollment period ended quietly Tuesday in the 36 states and some other states and there are early signs that it may have finished with strong signup activity, in spite of the lack of news coverage.

The COVID-19 pandemic seems to have diverted much of the media attention that has gone to the Affordable Care Act public exchange system and the annual open enrollment period in recent years.

However, a Google Trends search activity indicator showed a big spike in search activity for “” Tuesday. Consumers reported on Twitter and other social media services that getting through to call centers was taking an hour or more.

(Related: Beats 2019 Daily Signup Average)

About 5 million people had signed up for coverage through or a locally run exchange as of Dec. 9, according to, an ACA tracking blog.

The Background

Insurers, regulators and ACA public exchange plan managers developed the open enrollment period system, or limits, on when people can buy individual or family health coverage without showing they have what the government classifies as a good reason to be shopping for coverage, in an effort to push young, healthy people to pay for coverage even when they feel fine.

The idea is that young people may come to understand that, if they fail to pay for coverage, they could end up with health problems outside of the open enrollment period, and no way to pay their medical bills or to sign up for health coverage.

The open enrollment period system applies to all individual and family major medical insurance system sold in the United States, whether the coverage is sold inside or outside the ACA public exchange system.

The U.S. Department of Health and Human Services (HHS) provides ACA public exchange system services, or access to a web-based supermarket for health insurance, in 36 states.

Fourteen states and the District of Columbia have their own locally run public exchange programs.

The open enrollment period for 2021 coverage was set to run from Nov. 1 through Dec. 15 in the states and some states with locally run public exchange systems.

Signup Deadline Flexibility gave consumers who were already “in line” to sign up for coverage yesterday extra time to complete the signup process. Consumers who called the call centers, for example, were told a representative would call to help them within the next few days.

Managers of and Vermont Health Connect are examples of locally run exchange programs that appear to be sticking with a firm Dec. 15 signup deadline.

Many other states with locally run exchanges have set deadlines after Dec. 15, or have extended their deadlines.

The managers of is advertising a Dec. 22 deadline, and extended call center hours.

Managers of AccessHealthCT, Connecticut’s public exchange program, have extended their signup deadline to Jan. 15.

California, New York, New Jersey and the District of Columbia will let people sign up as late as Jan. 31.

— Read ACA Exchange System Keeps Growing in Its Core States, on ThinkAdvisor.

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