Why has ACA enrollment decreased?

Enrollment has fallen due to the expiration of enhanced premium tax credits at the end of 2025, causing average premiums for affected enrollees to more than double.[1]

What is the status of efforts to extend the enhanced tax credits?

The House passed a bill to extend the subsidies for three years, but it is now in the Republican-controlled Senate where its passage is uncertain amid partisan debates.

How might premiums change without the tax credit extension?

KFF estimates premiums could swell by an average of 114%, from $888 in 2025 to $1,904 in 2026 for over 20 million affected enrollees.[2]

What are the potential consequences if subsidies are not extended?

Analysts estimate millions could lose coverage, with the Congressional Budget Office projecting 4 million people will lose insurance; some may shift to employer or Medicaid plans or go uninsured.

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1M ago

Fewer Americans sign up for Affordable Care Act health insurance as costs spike

Enrollment in ACA plans has fallen as expiring enhanced tax credits raise premiums, leading many consumers to delay or forgo coverage while Congress debates extending subsidies.

Overview

A summary of the key points of this story verified across multiple sources.

CMS data show 22.8 million people have selected ACA plans for 2026, down about 800,000 from the same point last year, reflecting a 3.5% drop in enrollment.

Expiring enhanced premium tax credits that lowered costs through 2025 have ended, causing average premiums for affected enrollees to more than double without extension.

The House passed a bill to extend subsidies for three years, sending the measure to the Senate where its fate is uncertain amid partisan debate over costs and reforms.

Experts warn the enrollment snapshot is preliminary; some enrollees may cancel after receiving bills, and final effectuated enrollment could fall further.

Analysts estimate millions could lose coverage without an extension; some may seek employer or Medicaid coverage, while others may go uninsured and pay out-of-pocket.

Written using shared reports from

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Analysis

Compare how each side frames the story — including which facts they emphasize or leave out.

Center-leaning sources frame the story as an urgent consumer hardship driven by expired subsidies, using evaluative terms ('sinking sign-ups', 'fears'), selecting human anecdotes and health-economist warnings, and foregrounding partisan conflict while citing CBO cost estimates—emphasizing personal impact and fiscal trade-offs to shape concern and policy pressure.

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: CMS reports 22.8 million people have selected ACA plans for 2026, down about 800,000 (3.5%) from the same point last year.[1]
Sources:
KFF
: Enrollment has fallen due to the expiration of enhanced premium tax credits at the end of 2025, causing average premiums for affected enrollees to more than double.[1]
Sources:
CBS News
: The House passed a bill to extend the subsidies for three years, but it is now in the Republican-controlled Senate where its passage is uncertain amid partisan debates.
Sources:
ABC News
: KFF estimates premiums could swell by an average of 114%, from $888 in 2025 to $1,904 in 2026 for over 20 million affected enrollees.[2]
Sources:
CMS
: Analysts estimate millions could lose coverage, with the Congressional Budget Office projecting 4 million people will lose insurance; some may shift to employer or Medicaid plans or go uninsured.
Sources:
KFF