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Annual enrollment used to last for three months; the 2016 cycle lasted from November 1, 2015 to January 31, 2016. The 2018 annual enrollment cycle was reduced to 45 days (in most states) from November 1, 2017 to December 15, 2017. Acting during the annual enrollment period is vital for any individual who wishes to buy individual health insurance.

The open enrollment period for 2016 coverage ran from November 1, 2015 to January 31, 2016. State exchanges also have had the same deadlines; their performance has been varied. The design of the website was overseen by the Centers for Medicare and Medicaid Services and built by a number of federal contractors, most prominently CGI Group of Canada.

In the first year of operation, open enrollment on the exchanges ran from October 1, 2013, to March 31, 2014, and insurance plans purchased by December 15, 2013, began coverage on January 1, 2014. For 2015 open enrollment began on November 15, 2014 and ended on February 15, 2015.