Enrollment Decline in New Hampshire Health Insurance Marketplace

The New Hampshire Insurance Department has reported a 4.1% decrease in health insurance marketplace enrollments for 2026, with approximately 73,090 individuals signing up. This decline marks a shift from 2025, which saw a record-breaking 76,251 enrollments in ACA plans. The reduction in enrollments follows a growth trajectory that began during the COVID-19 pandemic, but pandemic-era subsidies that helped reduce insurance costs expired at the end of 2025, according to the Centers for Medicare & Medicaid Services.

Andrew Demers from the New Hampshire Insurance Department highlighted that the impact of the enrollment drop was dampened by the state's low ACA benchmark premiums, even as the federal government opted not to extend health insurance tax credits. New Hampshire maintained an uninsured rate of 4.5% in 2024, with future projections from the Congressional Budget Office suggesting a rise in the national uninsured rate from 7.6% in 2025 to 10.1% by 2028. Demers emphasized the state's commitment to evaluating affordability through elements like premiums, deductibles, and cost-sharing, while acknowledging ongoing challenges posed by escalating healthcare costs.

The decrease in New Hampshire's enrollments reflects a larger national trend. A KFF report detailed a decline of over a million in ACA plan enrollments during the 2026 open enrollment period, the largest drop since the establishment of the marketplace. The report cites CMS, state marketplaces, and KFF survey data, noting Massachusetts saw an enrollment increase due to allocating $250 million from a state trust fund to counteract the end of federal health insurance subsidies. Similarly, Connecticut experienced a rise in sign-ups, attributed to state funding aimed at offsetting these federal subsidy losses.