Enhanced premium tax credits that had lowered ACA marketplace premiums since 2021 expired on December 31, 2025, and the first federal enrollment figures for 2026 show the effect: about 22.8 million plan selections nationwide, roughly 1.2 million fewer than the year before, per CMS's 2026 Open Enrollment Period national snapshot released in January 2026. Of those selections, 2.8 million were new consumers and 20.0 million were returning ones.
This article publishes information, not insurance advice. If you are weighing coverage options after a premium increase, a licensed broker or your state marketplace can review your specific numbers.
Why did marketplace premiums jump for 2026?
The enhanced subsidies, expanded during the COVID-19 pandemic, capped marketplace premiums at a lower share of income and extended eligibility to households above 400% of the federal poverty level. When Congress did not extend them, that cap disappeared for plan year 2026. Analysis from the Commonwealth Fund put the national enrollment decline at about 5 percent, with new enrollment down roughly 14 percent — the steepest drop, because higher gross premiums hit shoppers without subsidies hardest.
Related stories: Aetna Finished Its ACA Marketplace Exit: What Members Should Check Now · CMS Finalizes 2.48 Percent Medicare Advantage Rate Increase for 2027.
Who was affected first?
Shoppers with incomes above 400% of the poverty line lost subsidy help entirely and in several states faced the largest dollar increases. Households at lower incomes still receive the original premium tax credits, but many saw their share of premium rise. In the 30 states using HealthCare.gov, open enrollment for 2026 ran November 1, 2025 through January 15, 2026, per CMS.
What happens to people who did not enroll?
Anyone who let coverage lapse can still qualify for a special enrollment period after losing minimum essential coverage, moving, or through other life events. Medicaid and CHIP accept applications year-round. A person who missed the January 15 deadline in a HealthCare.gov state should check whether a qualifying event applies before assuming they must wait until November 2026.
What to watch next
State-based marketplaces will publish final enrollment tallies through the spring, and insurers will file 2027 rates in the summer with the subsidy lapse baked into their assumptions. If you kept a 2026 plan, re-check your income estimate in your marketplace account: a corrected projection can change your tax credit at reconciliation time, and reporting a raise mid-year is cheaper than repaying an overpayment next filing season.
For more context, read Aetna Finished Its ACA Marketplace Exit: What Members Should Check Now.
For more context, read unitedhealth q2 2026 earnings.
For more context, read UnitedHealth's Q1 2026 Cost Ratio Eased to 83.9 Percent.