ACA Individual Enrollment Slows Amid Uncertainty Over Premium Subsidies

Enrollment in individual health insurance plans under the Affordable Care Act (ACA) for 2026 has not reached the levels seen at the same time in the previous year, according to the Centers for Medicare & Medicaid Services (CMS). As of the latest reporting, approximately 950,000 new consumers without current individual market coverage have signed up, compared to nearly 988,000 at the comparable period last year. This early enrollment trend occurs amid ongoing congressional deliberations over whether to extend enhanced tax credits that subsidize premiums for ACA plans. These enhanced tax credits were originally implemented in 2021 to improve affordability and broaden access to health insurance. They have contributed to a record high ACA enrollment of 24 million people, with about 22 million receiving these subsidies. However, these tax credits are set to expire at the end of the year unless Congress acts to renew them, which could result in a substantial increase in premiums, averaging a 114% rise according to Kaiser Family Foundation data. Despite the uncertainty regarding the continuation of subsidies, most current consumers are actively renewing their coverage, and CMS noted that individuals who do not actively renew will be automatically re-enrolled for 2026. Current data show 5.75 million plan selections across all exchanges, including 4.8 million returning consumers, indicating strong retention amongst existing enrollees. The ACA open enrollment period began on November 1, 2025, and runs through December 15. A recent Kaiser Family Foundation poll suggests a significant risk of coverage loss if subsidies are not extended, with one in four enrollees indicating they may not retain coverage due to unaffordable premiums. The poll also revealed broad bipartisan support for extending the subsidies, including a majority of Republican enrollees. Meanwhile, legislation aimed at extending the enhanced tax credits for two more years has been introduced in the U.S. House of Representatives, though no agreement has yet been reached. The outcome of these policy discussions will have important implications for ACA enrollment trends, premium costs, insurer risk pools, and overall market stability. Insurance professionals should monitor ongoing federal policy developments closely, as they will shape the individual health insurance market dynamics and regulatory compliance requirements in the coming enrollment periods. The continuation or cessation of premium subsidies will directly influence consumer demand, payer/provider negotiations, and insurer coverage strategies within the ACA marketplaces.