After several down years when the fate of the Affordable Care Act was cloudy at best, exchange enrollment has begun growing again, with its biggest boost coming from COVID-19 special enrollment periods in 2020 and 2021. Attracting nearly 1 million people during 2021s COVID-19 special enrollment period, some retraction in the exchange markets is inevitable. But the marketplaces have matured and most counties have multiple plan choices.

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