ACA Marketplace Enrollments for 2026 Slightly Ahead of Last Year
Preliminary federal data released today show nearly 5.8 million people have selected marketplace plans for 2026, about 400,000 more than at the same point in 2024, a modest but notable increase. With open enrollment running through December 15 for coverage starting January 1, policymakers and community advocates are watching closely as temporary enhanced subsidies expire and premiums are expected to rise for many.
KFF Health News reported on December 9, 2025 that preliminary federal data show Affordable Care Act marketplace plan selections for 2026 are modestly outpacing enrollments at a comparable point last year. Nearly 5.8 million people had selected plans in the latest snapshot, about 400,000 more than were enrolled at the same time in 2024. The enrollment period remains open through December 15 for coverage beginning January 1, 2026, and officials cautioned that the snapshot does not represent final totals.
The gains reflect a mix of outreach work by consumer groups and state marketplaces, persistent demand for coverage and lingering uncertainty about the cost of care next year. At the same time, analysts warned that coverage costs are expected to rise for many consumers because temporary enhanced tax credits that lowered premiums for millions are set to expire at the end of 2025. That change is likely to increase premiums for a substantial share of enrollees and could prompt some people to forgo or abandon coverage before the enrollment window closes.
Public health experts say early enrollment momentum matters because continuity of coverage translates into more consistent access to primary care, preventive services and medications. Higher early uptake could blunt some near term disruptions in care for people who have relied on marketplace plans to manage chronic conditions. However, the projected rise in premiums risks widening disparities if low and moderate income households reduce coverage or choose less comprehensive plans to control costs.
Community health centers and local navigators have reported heavier than usual demand for enrollment assistance this season, particularly in areas with large numbers of uninsured residents and communities of color. Those populations have historically faced greater barriers to both enrollment and care, including language access issues, limited broadband and unstable employment. Advocates say targeted outreach and in person assistance remain crucial as the enrollment clock winds down.
Policy implications are coming into sharper relief. Lawmakers and administration officials will be watching final enrollment figures as they weigh proposals on whether to extend enhanced subsidies or craft other budget measures to ease premium shocks. The KFF briefing also highlighted related state and legal developments that could affect networks, benefit rules and the broader affordability landscape for next year. Those decisions will shape how many people ultimately keep coverage and how effectively the system protects people with chronic illnesses and limited incomes.
As open enrollment ends, enrollment dynamics will provide lawmakers and advocates with a clearer picture of how subsidy changes translate into real world coverage outcomes. For people on the margins of affordability, the weeks ahead may determine whether they can maintain health coverage in 2026, and for communities already facing health inequities, those choices will carry consequences for access to care and financial stability.
