health
ACA enrollment may fall by 5 million people this year, analysis finds
Enrollment in the health insurance marketplace may plummet amid a lapse in federal subsidies that reduced insurance premiums for millions of people.
TL;DR
- Marketplace enrollment could drop by 5 million people (21.5%) from 22.3 million in 2025 to 17.5 million in 2026.
- Higher costs are triggered by the lapse of federal subsidies for healthcare premiums.
- Average ACA premiums are estimated to spike by 114% following the lapse of enhanced premium subsidies.
- Households switched to lower-premium, higher-deductible plans, causing average premiums to rise 58% to $178/month.
- Average deductibles increased by 37% to $3,786 in 2026.
- About 23 million people enrolled for 2026 coverage, a decline of 1.5 million from 2025, the sharpest single-year drop.
- A significant number of enrollees are expected to lose coverage midyear in 2026 due to inability to pay premiums.