Projections Indicate Over 1 Million Drop in Obamacare Enrollment by 2026

Enrollment in Obamacare plans is projected to decline by over 1 million Americans by 2026. This trend is largely attributed to rising monthly premiums and the expiration of enhanced federal subsidies for health insurance that were introduced during the COVID-19 pandemic.

The Centers for Medicare and Medicaid Services (CMS) released a report indicating that 23 million consumers signed up for individual health insurance coverage through the Marketplaces during the 2026 open enrollment period. This figure includes 15.8 million selections from states utilizing the HealthCare.gov platform and 7.2 million from state-based exchanges.

Enhanced subsidies that were available during the pandemic expired at the end of last year after Congress failed to reach an agreement for their extension. However, the original subsidies established under the Affordable Care Act remain in effect. According to data from KFF, the average total premium costs for subsidized Obamacare enrollees are expected to rise dramatically, increasing from $888 to an average of $1,904 in 2026.

OBAMACARE PRICES ARE SET TO SPIKE – HERE’S WHY

An analysis by KFF revealed that as of mid-January, enrollment had decreased by approximately 1.2 million consumers compared to the 24.2 million who had enrolled at the same time last year.

Congress failed to reach an agreement to extend the COVID-era enhanced subsidies for Obamacare plans. (Anna Moneymaker/Getty Images)

KFF noted that the enrollment data released at this stage reflects automatic renewals and plan selections, which may not necessarily lead to actual enrollments, as some individuals may ultimately decide against paying for their plans. In 2025, over 40% of sign-ups were from automatic renewals. KFF explained that as returning consumers receive their initial bills from insurers, they may opt not to pay the premium, leading to loss of coverage or disenrollment.

HOW ARTIFICIAL INTELLIGENCE IS TRANSFORMING HEALTHCARE

Health insurance costs are expected to surge in 2026. (Getty Images)

The group cautioned that without the enhanced premium tax credits, the rate of effectuated enrollments or premium payments may decline compared to previous years. This could lead to a more significant drop in the final enrollment data.

KFF conducted a poll indicating that premium payments are expected to more than double on average in 2026. Alarmingly, about 25% of enrollees stated they would forgo health insurance this year if their premiums doubled as anticipated.

MIDDLE-INCOME AMERICANS STRUGGLING TO KEEP UP AS LIVING COSTS WEIGH ON PAYCHECKS, SURVEY SAYS

Obamacare enrollment figures won’t be finalized until after the 90-day grace period for paying premiums expires. (Matt McClain/The Washington Post via Getty Images)

Analysts anticipate a further decline in total enrollment in Obamacare plans as consumers become aware of the increased premiums and may choose to let their coverage lapse instead of paying the higher costs. “Given the 90-day grace period, which should apply to the majority of ACA members, we foresee significant disenrollment activity during this time, leading to a lower final enrollment number,” stated Evercore ISI analyst Elizabeth Anderson.

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Enrollment on HealthCare.gov continued through January 15, 2026, although deadlines for state-based exchanges may vary.

Reuters contributed to this report.

Enrollment in Obamacare plans is projected to decline by over 1 million Americans by 2026. This trend is largely attributed to rising monthly premiums and the expiration of enhanced federal subsidies for health insurance that were introduced during the COVID-19 pandemic.

The Centers for Medicare and Medicaid Services (CMS) released a report indicating that 23 million consumers signed up for individual health insurance coverage through the Marketplaces during the 2026 open enrollment period. This figure includes 15.8 million selections from states utilizing the HealthCare.gov platform and 7.2 million from state-based exchanges.

Enhanced subsidies that were available during the pandemic expired at the end of last year after Congress failed to reach an agreement for their extension. However, the original subsidies established under the Affordable Care Act remain in effect. According to data from KFF, the average total premium costs for subsidized Obamacare enrollees are expected to rise dramatically, increasing from $888 to an average of $1,904 in 2026.

OBAMACARE PRICES ARE SET TO SPIKE – HERE’S WHY

An analysis by KFF revealed that as of mid-January, enrollment had decreased by approximately 1.2 million consumers compared to the 24.2 million who had enrolled at the same time last year.

Congress failed to reach an agreement to extend the COVID-era enhanced subsidies for Obamacare plans. (Anna Moneymaker/Getty Images)

KFF noted that the enrollment data released at this stage reflects automatic renewals and plan selections, which may not necessarily lead to actual enrollments, as some individuals may ultimately decide against paying for their plans. In 2025, over 40% of sign-ups were from automatic renewals. KFF explained that as returning consumers receive their initial bills from insurers, they may opt not to pay the premium, leading to loss of coverage or disenrollment.

HOW ARTIFICIAL INTELLIGENCE IS TRANSFORMING HEALTHCARE

Health insurance costs are expected to surge in 2026. (Getty Images)

The group cautioned that without the enhanced premium tax credits, the rate of effectuated enrollments or premium payments may decline compared to previous years. This could lead to a more significant drop in the final enrollment data.

KFF conducted a poll indicating that premium payments are expected to more than double on average in 2026. Alarmingly, about 25% of enrollees stated they would forgo health insurance this year if their premiums doubled as anticipated.

MIDDLE-INCOME AMERICANS STRUGGLING TO KEEP UP AS LIVING COSTS WEIGH ON PAYCHECKS, SURVEY SAYS

Obamacare enrollment figures won’t be finalized until after the 90-day grace period for paying premiums expires. (Matt McClain/The Washington Post via Getty Images)

Analysts anticipate a further decline in total enrollment in Obamacare plans as consumers become aware of the increased premiums and may choose to let their coverage lapse instead of paying the higher costs. “Given the 90-day grace period, which should apply to the majority of ACA members, we foresee significant disenrollment activity during this time, leading to a lower final enrollment number,” stated Evercore ISI analyst Elizabeth Anderson.

GET FOX BUSINESS ON THE GO BY CLICKING HERE

Enrollment on HealthCare.gov continued through January 15, 2026, although deadlines for state-based exchanges may vary.

Reuters contributed to this report.