Health Care Newsletter

ACA enrollment data shows impact of expired tax credits

by Joseph Choi and Nathaniel Weixel - 05/19/26 6:40 PM ET

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by Joseph Choi and Nathaniel Weixel - 05/19/26 6:40 PM ET

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- Presented by Coalition to Strengthen America’s Healthcare

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Health Care

The Big Story

Impact of expired ACA tax credits comes into view

We may now be starting to see the impact of congressional Republicans’ decision not to extend ObamaCare’s enhanced premium tax credits.

Enrollment in the health law’s insurance exchanges is projected to drop by roughly 5 million people this year relative to 2025, according to a new analysis from KFF, as enrollees face higher costs due to the expiration of the enhanced subsidies.

The analysis found enrollment could decline to roughly 17.5 million people in 2026, down from 22.3 million people last year.

Premium payments from enrollees increased by an average of 58 percent, from $113 to $178 per month. That’s lower than the 114 percent increase KFF projected last fall because many people bought cheaper, higher-deductible plans rather than staying with the same coverage.

Households with the steepest increases dropped ACA coverage at higher rates.

About 9.2 million people signed up for “bronze” level plans, up from 7.3 million in 2025. Bronze plans cost less up front but with high deductibles, they will cost more if people need to use the coverage.

As a result, average deductibles increased by 37 percent, more than $1,000 per person to a record high of $3,786 in 2026.

“This is the steepest increase in deductibles ever seen in this market,” KFF noted.

The Trump administration and conservative think tanks like the Paragon Health have downplayed the losses, saying they are mostly the result of a drop in fraudulent or improper enrollments.

Congressional Democrats shut down the government for a record 43 days last year but failed to get an extension of the enhanced credits in return for their support on voting to reopen the government.

Instead, Republicans promised to give them a vote on a bill of their choosing to extend the subsidies. The vote failed, and the subsidies expired at the end of 2025.

Insurers cited the expiring extra subsidies as one of the reasons they charged higher premiums this year, as they anticipated healthier people would drop coverage.

Welcome to The Hill’s Health Care newsletter, we’re Nathaniel Weixel and Joseph Choi — every week we follow the latest moves on how Washington impacts your health.

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