1.4 million fewer people enrolled in ACA plans as premiums spike, tax credits expire
About 1.4 million fewer people have signed up for Affordable Care Act (ACA) plans compared to the same time last year in the face of increasing premium costs and expired tax credits, new federal data shows.
The data, updated Monday from the Centers for Medicare & Medicaid Services, includes those who signed up via Healthcare.gov through Jan. 3 and those who signed up with state-run ACA marketplaces through Dec. 27.
Last year, there were about 24.2 million people who had selected a plan through the marketplace by this time last year, including 3.9 million new customers.
As of Jan. 12, there have been 22.8 million consumers who selected a plan with 2.8 million new customers.
The deadline in most states to sign up for health insurance under the ACA is Thursday, Jan. 15.
One reason is likely the expiration of ACA subsidies, experts told ABC News. Also known as premium tax credits, they help lower or eliminate the out-of-pocket cost of monthly premiums for those who purchase insurance through the health insurance marketplace.
The subsidies were part of the original ACA passed during the Obama administration and were enhanced during the COVID-19 pandemic to increase the amount of financial assistance to those who were already eligible and to expand eligibility to more people.
The majority of ACA marketplace enrollees were receiving enhanced premium tax credits to lower their monthly premiums, and many were preparing to see their premiums rise in 2026.
In October and November, the subsidies became a sticking point during the longest government shutdown in U.S. history.
Republicans said the expansions from the pandemic era went too far and tried to persuade Democrats to fund a temporary spending bill that didn't address the expiring ACA subsidies, with promises of discussing ways to continue the subsidies later.
Meanwhile, Democrats insisted on extending the premium tax credits as part of a bill to end the shutdown, warning that their expiration could be detrimental for millions of American families.
In early November, the Senate reached a bipartisan deal to end the shutdown -- which did not include any of the Democratic demands on health care. Eight Democrats voted with Republicans, and the bill was later also passed by the House.
Sources told ABC News that Republican leadership promised to allow a vote on a bill of Democrats' choosing related to the ACA in December, but a pair of competing health care-related bills failed to advance in the Senate earlier this month.
Earlier this month, the House passed a Democratic-led bill that would see the enhanced premium tax credits extended by three years.
Estimates from the Congressional Budget Office have suggested that, without an extension, gross benchmark premiums -- the price of a standard plan before government subsidies are applied -- could increase by 4.3% in 2026 and by 7.7% in 2027 for those on marketplace plans.
A KFF analysis last year found that people who buy insurance from the marketplace, and receive financial assistance, would see their premiums rise by about 114% on average, from $888 in 2025 to $1,904 in 2026.
