Affordable Care Act Enrollment Shows Early Signs of Decline Amid Subsidy Expiration

Early enrollment data from multiple states indicate a potential decline in Affordable Care Act (ACA) coverage renewals and an increase in plan switching toward lower-cost options for the 2026 enrollment period. States including New York, Pennsylvania, Idaho, Colorado, and California report that more consumers are either dropping their ACA plans or opting for bronze-tier plans, which have lower premiums but higher out-of-pocket costs. This trend may reflect affordability challenges as enhanced federal subsidies are scheduled to expire, potentially resulting in notable premium hikes for many enrollees. The Senate's recent rejection of a bill to extend enhanced subsidies for another three years casts uncertainty over future ACA affordability. Without these tax credits, millions of consumers could face double-digit premium increases, influencing enrollment behaviors and plan selections. Early state-level data show varied impacts, such as Pennsylvania experiencing over a 100% rise in premiums, contributing to a 20% drop in first-time enrollments and a doubling of coverage cancellations so far. Idaho, which opened its enrollment period two weeks earlier than most states, is seeing a tangible shift from silver and gold plans to bronze plans, indicating consumer cost sensitivity. Calls to cancel coverage citing affordability have increased significantly. Yet, new enrollments are partially offsetting these drops. Similarly, in California and New York, overall enrollment is down, with substantial movement toward bronze plan selections, signaling budget-driven decisions among consumers. CMS nationwide data shows an overall moderate increase in ACA plan selections compared to last year, with nearly 5.8 million people selecting plans early in the open enrollment season. However, experts caution these early figures may not fully represent the final enrollment picture due to delayed decision-making amid subsidy uncertainties. Automatic renewals and consumer reassessments in December may lead to higher disenrollment rates post-enrollment. Market observers emphasize that this enrollment cycle is distinct from previous years, characterized by pronounced financial pressures on consumers and evolving federal policies. The combination of subsidy expirations, anticipated premium increases, and consumer cost concerns is reshaping enrollment patterns across state marketplaces. Stakeholders are monitoring these shifts closely as they carry implications for coverage continuity, insurer risk pools, and overall ACA market stability heading into 2026.