KFF Health News Nov 4 2025 This year's Obamacare open enrollment period, which started Nov. 1 in most states, is full of uncertainty and confusion for the more than 24 million people who buy health insurance through the federal and state Affordable Care Act marketplaces. Even with sign-up season underway, the fate of the enhanced premium tax credits that make coverage more affordable for 92% of enrollees remains up in the air, with the prospect of significantly higher premiums looming. But