A new analysis from KFF estimates that ACA Marketplace enrollment could decline by nearly 5 million people in 2026 following the expiration of enhanced premium tax credits at the end of last year. According to the report, average Marketplace enrollment could fall from 22.3 million people in 2025 to approximately 17.5 million in 2026 as consumers face significantly higher coverage costs.

The analysis found that average monthly premium payments increased by 58% in 2026, contributing to coverage losses and shifts in plan selection. Average ACA Marketplace deductibles also saw the steepest increase in the history of the exchanges, rising 37% — more than $1,000 per person — to an average deductible of $3,786.

KFF noted that more consumers are moving into lower-premium bronze plans with higher out-of-pocket costs. Bronze plan selections increased from 30% to 40% of Marketplace enrollment between 2025 and 2026, while enrollment in silver plans declined to a record low.

The findings come amid ongoing debate over the impact of enhanced subsidy expiration and broader concerns about affordability and access in the individual market.

Source: National Association of Benefits and Insurance Professionals