2026 ACA Marketplace Trends: Enrollment Declines and Plan Shifts
The Centers for Medicare and Medicaid Services (CMS) has published its annual data on consumer premiums and plan selections within the Affordable Care Act (ACA) marketplaces. The analysis of the 2026 open enrollment data reveals trends such as a decline in overall enrollment, changes in plan preferences, and an increase in average premiums. These insights emphasize the evolving landscape of the health insurance market.
In 2026, ACA marketplace enrollment nationwide decreased by 4.9% compared to the previous year. Arkansas, in particular, experienced a 3.8% drop, impacting individuals with incomes below 200% or above 400% of the federal poverty level. The Arkansas Insurance Department reported a higher rate of coverage drop-offs, with 10.1% of enrollees discontinuing their plans between February and April 2026, compared to 4.9% in 2025. As of April 2026, the state's marketplace enrollment stood at 134,310, indicating a 12% decrease from the previous year.
Consumer Plan Preferences and Pricing Strategies
A notable shift in consumer plan preferences emerged during this period. Enrollment in silver plans halved, while gold plans surged in popularity, and bronze plans experienced a modest increase. This change is largely due to insurers' strategic pricing adjustments and the conclusion of enhanced premium tax credits (APTCs). Meanwhile, platinum plans, newly introduced in Arkansas, saw minimal uptake, and catastrophic plans remained unpopular despite expanded federal eligibility.
Arkansas's average benchmark premiums increased in 2026, influenced by the practice of "silver loading." This strategy adjusts silver plan premiums to generate larger tax credits, making gold plan premiums more competitive and often more affordable than silver plans when adjusted for income. As a result, a considerable number of lower-income purchasers opted for gold plans due to these financial dynamics. Future reports will explore how consumers are responding to these premium adjustments and the implications for the insurance industry.