ACA Marketplace Enrollment Declines as Enhanced Premium Tax Credits Expire
In 2026, the Affordable Care Act (ACA) Marketplaces experienced a significant decline in enrollment following the expiration of enhanced premium tax credits. According to the Department of Health and Human Services, enrollment fell by nearly three million people from 2025 to 2026. The effectuation rate, which measures the percentage of enrollees who maintain their coverage by paying premiums, also decreased. States that implemented their own subsidy programs, like New Mexico, saw higher effectuation rates and smaller enrollment declines. The expiration of federal tax credits led to increased premium payments, contributing to the drop in enrollment as many consumers faced higher costs. 
