Key Highlights
- About 1.4 million fewer people have signed up for ACA plans in the face of increasing premium costs and expired tax credits.
- The deadline to sign up for health insurance under the ACA is Thursday, Jan. 15.
- Average premiums are expected to rise significantly as premium tax credits expire.
Overview of ACA Plan Enrollment Decline
About 1.4 million fewer people have signed up for Affordable Care Act (ACA) plans compared to the same time last year, a significant drop attributed to rising premium costs and expired tax credits. This data is from federal updates by the Centers for Medicare & Medicaid Services, covering enrollment through Jan. 3 via Healthcare.gov and Dec. 27 on state-run ACA marketplaces.
Impact of Expired Tax Credits
The primary reason for the decline in enrollment is likely the expiration of premium tax credits, which were a crucial component of reducing out-of-pocket costs for those purchasing health insurance through the marketplace. These subsidies have been part of the ACA since its inception and were enhanced during the COVID-19 pandemic to provide more financial assistance.
Rising Premiums and Financial Burden
Without these tax credits, many consumers are faced with higher monthly premiums. Estimates from the Congressional Budget Office suggest that gross benchmark premiums could increase by 4.3% in 2026 and by 7.7% in 2027 for those on marketplace plans. A KFF analysis found that people buying insurance through the ACA would see their premiums rise by about 114%, from $888 in 2025 to $1,904 in 2026.
Policy Expert Analysis
Experts highlight that the expiration of these subsidies could have significant implications for millions of American families. Dr. Ezekiel Emanuel, an architect of the ACA, discussed rising healthcare costs and the impact on policyholders in interviews with ABC News’ Linsey Davis. His book, “Eat Your Ice Cream: Six Simple Rules For a Long and Healthy Life,” provides additional insights into these financial challenges faced by individuals.
Timeline and Future Implications
The deadline to sign up for health insurance under the ACA is Thursday, Jan. 15, with the majority of states having this as their final day for enrollment. This period is crucial for ensuring coverage begins on February 1, 2026.
Despite efforts by both Democrats and Republicans, a bipartisan agreement to extend these subsidies has not been reached. The longest government shutdown in U.S. history, which lasted from October through December 2025, further complicated the situation as negotiations over funding and health care policies remained contentious.
The future of ACA subsidies remains uncertain, with significant implications for healthcare affordability. As premium costs continue to rise, policymakers will need to find solutions that balance the needs of consumers while maintaining the integrity of the ACA marketplace.
