ACA Marketplace Coverage for 2026 Surpasses Prior Year Enrollment

Nearly 5.8 million Americans have enrolled in health plans through the Affordable Care Act (ACA) marketplaces for 2026 coverage as of late November, surpassing last year's enrollment by approximately 7%. The open enrollment period continues through mid-January, with December 15 as the key deadline for coverage starting January 1. However, about 17 million current ACA members have yet to re-enroll for the upcoming year. Enhanced premium tax credits that help reduce ACA plan costs are set to expire at the end of 2025, with Senate votes scheduled to decide extensions or modifications. Proposals include a three-year extension of enhanced subsidies and the Crapo-Cassidy bill, which focuses on funding cost-sharing reductions, expanding catastrophic plan access, and introducing Health Savings Accounts for exchange enrollees. New consumer enrollments have slightly decreased by around 4% compared to last year, with fewer first-time sign-ups. However, returning enrollees account for a 10% increase, indicating strong retention within the ACA marketplaces. State-based exchanges demonstrated accelerated growth with a 22% rise in plan selections, exceeding the 4% growth seen on the federally-run Healthcare.gov platform. Florida and Texas lead the market in total enrollments, with increases of 16% and 17% respectively, underscoring regional diversity in marketplace performance. Auto re-enrollment mechanisms remain significant, particularly within state-run exchanges, where over 5.3 million consumers were automatically re-enrolled, a growth from 5 million the previous year. The data highlights ongoing efforts to maintain continuous coverage and minimize lapses. While Healthcare.gov auto re-enrollment data was not provided, the trend suggests a continued emphasis on streamlined renewal processes. The current enrollment dynamics occur amid legislative uncertainty around ACA premium tax credits, which influence consumer affordability and insurer participation. The competing Senate proposals reflect policy discussions balancing coverage cost support, plan design adjustments, and consumer choice enhancements. These developments have important implications for payers, providers, and policymakers monitoring market stability and regulatory compliance as the ACA enters its next coverage cycle.