Analysis finds Marketplace enrollment could fall by at least 17% in 2026

A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels, plan selections and out-of-pocket costs for Health Insurance Marketplace enrollees in 2026. It found that average monthly effectuated enrollment could fall in 2026 to nearly 17.5 million, or potentially as low as 16.5 million — down from 22.3 million in 2025. Enrollee premiums increased by an average of 58% from $113 to $178 per month. Average Marketplace deductibles grew by 37%, or $1,027 per person, to a record $3,786 in 2026. The analysis used data from the Centers for Medicare & Medicaid Services, state-based marketplace open enrollment reports, KFF survey data and individual market enrollment estimates from Wakely Consulting Group.