on PinterestMillions of Americans are expected to lose their ACA plans amid rising premium costs.
on PinterestMillions of Americans are expected to lose their ACA plans amid rising premium costs. Fiordaliso/Getty Images
- Around 1.4 million fewer Americans have enrolled in Affordable Care Act (ACA) health insurance plans in 2026 due to the expiration of federal subsidies that help offset monthly premium costs.
- People who enroll in Obamacare programs will pay an average of 114% more in premiums.
- There are various alternative plans available for those who can’t afford ACA premiums, but experts say many are still expensive or do not provide adequate coverage.
Fewer people will participate in Affordable Care Act (ACA) health insurance plans in 2026, and those who do will pay significantly more for their medical expenses.
The window for enrolling in ACA programs closed on January 15. This year, it appears fewer people will be enrolled in ACA health plans.
New data from the Centers for Medicare & Medicaid Services (CMS) show that 22.8 million people enrolled in ACA marketplace coverage in 2026, down from a record 24.2 million in 2025. That’s about 1.4 million fewer people.
The numbers for 2026 enrollment include those who signed up for ACA plans via Healthcare.gov through January 3, and those who enrolled via state-operated ACA marketplaces through December 27.
The downward enrollment trend this year is attributed to rising premium costs.
In 2025, an estimated 22 million people used federal subsidies to lower their health insurance premiums. Some of them paid no premiums at all. However, in 2026, none of the ACA enrollees will receive federal subsidies to help them pay their premiums.
That’s because Congress hasn’t renewed those assistance programs, which were approved in 2021 under the American Rescue Plan and then extended through 2025 under the Inflation Reduction Act of 2022.
In early January, the House of Representatives voted to extend the subsidies for three years, but the Senate hasn’t yet approved the extension. President Donald Trump has said he may veto legislation extending the subsidies, even if Congress approves it.
When the President unveiled “The Great Healthcare Plan” in mid-January, proposing lower costs and prescription drug pricing, experts said the affordability it promised is unlikely to be delivered.
“We know President Trump wants his plan to be a great health plan, but unfortunately, his plan keeps in place the infrastructure that is hurting patients, doctors, and prices today,” Twila Brase, RN, PHN, co-founder and president of Citizens’ Council for Health Freedom, said in a statement.
Here’s what you need to know about rising costs to ACA premiums and some of the available alternatives to Obamacare.
How much will ACA premiums go up in 2026?
Health insurers participating in the ACA marketplace are projected to raise their premiums by an average of 26%.
It’s been estimated that nearly 5 million people in the United States will decide to forgo health insurance this year rather than pay the additional costs.
Those who remain in the ACA system will pay an average of 114% more in health insurance premiums due to the lack of subsidies, according to a report by the organization KFF.
The Bipartisan Policy Center estimates that a family of
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