ACA enrollment sinks sharply as coverage costs soar in 2026

New federal data shows far fewer Americans are enrolling in Affordable Care Act health care plans, leaving millions facing higher premiums after tax subsidies for the insurance plans expire in December

According to the Centers for Medicare and Medicaid Services (CMS), 22.8 million people have signed up for 2026 ACA coverage since open enrollment began on November 1. That’s 1.4 million fewer Americans enrolled in Obamacare, as it’s known as the health plan, than a year ago.

Nationally, about 800,000 fewer people are choosing plans compared with this time last year, and total enrollment is down 3.5% so far. This includes decreases in new consumers enrolling in ACA plans and existing participants re-enrolling in ACA plans.

ACA open enrollment for February coverage ends January 15 in most states.

The enrollment decline comes as many ACA enrollees face steep increases in monthly premiums as tax credits expire on Dec. 31, lowering monthly health plan costs for families. After months of debate and Government shutdown for six weeksCongress has yet to extend the credit line or agree on other remedies.

The House of Representatives approved legislation last week that would keep the increased subsidies in place for another three years. The fate of the bill now rests with Republican controlled Senate.

Last year, more than 20 million Americans received ACA subsidies. Health policy group KFF estimates that unless the tax credit is extended, their premiums could rise an average of 114%, from about $888 in 2025 to $1,904 this year.

Experts warn that the end of subsidies could prompt more people to drop coverage amid rising premiums and out-of-pocket costs. The nonpartisan Congressional Budget Office estimates that 4 million people will eventually lose coverage if the credit is not extended.

Some ACA enrollees who drop coverage may have other options, such as enrolling in a partner employer health plan or changing income to qualify for Medicaid, said Robert Kaestner, a health economist at the University of Chicago. others may Go without insurance as they look for alternatives.

“My prediction is that 2 million more people are going to be without health insurance for a period of time,” Kestner told The Associated Press. “It’s a serious problem, but Republicans will argue that we’re using government money more efficiently, we’re targeting the people who really need the money, and we’re saving $35 billion a year.”