ACA Enrollment Declines as Subsidies Expire, Leaving Millions Facing Soaring Premiums
Millions of Americans are facing a critical juncture in healthcare access as the window to enroll in Affordable Care Act (ACA) plans for coverage beginning in February has closed, coinciding with the expiration of key federal subsidies. The lapse in financial assistance is driving up costs and creating deep uncertainty for those who rely on the ACA for affordable health insurance.
The enrollment deadline arrived as expanded subsidies – initially implemented during the COVID-19 pandemic – expired on January 1, sharply increasing premiums for many. This comes at a notably vulnerable time for individuals and families who do not receive health insurance through their employers, including small business owners, gig workers, early retirees, farmers, and stay-at-home parents. Last year saw a record 24 million Americans secure ACA coverage, but this year’s enrollment numbers are lagging.
As of this month, approximately 22.8 million people have signed up for ACA plans, roughly 800,000 fewer than at the same point last year, according to federal data. Both new enrollments and renewals are down, signaling a growing concern among potential beneficiaries. The expiration of subsidies, which offset costs for over 90% of enrollees, is the primary driver of this decline. The non-profit KFF estimates that the average subsidized enrollee now faces more than double their monthly premium for 2026.
Despite a recent effort by the House of Representatives to pass a three-year extension of the subsidies, the Senate previously rejected similar legislation, leaving the future of these critical funds in doubt. The political stalemate over the subsidies even contributed to the record-breaking 42-day government shutdown last year, with Democratic lawmakers refusing to compromise without a commitment to extending the ACA funding.
The impact of these rising costs is already being felt across the country. In Maine, Emily, a 64-year-old with multiple sclerosis, says the increase in her family’s annual healthcare costs will push her family’s annual healthcare costs to roughly $6,484 – nearly 15% of their total income – before even meeting their deductible. “We would face unachievable choices,” she said. “Without the care that keeps me alive and functioning, I would lose my vision, my mobility, and my independence.”
Even those who have opted out of the ACA marketplace are feeling the pressure. Brian bonnet, a 55-year-old retiree in California’s Central Valley, found ACA premiums higher than continuing coverage through COBRA.he now pays $900 a month for insurance without dental or vision, and worries he may need to return to work solely to secure health benefits. “If my Cobra plan goes up too much, I will need to go back to work just for the health insurance,” Bonnet said, adding that the job market in his area is “not great.”
In Knoxville, Tennessee, Sara Hill, a former elementary school teacher and mother of three, saw her family’s monthly premium jump from $250 in 2025 to $1,007 in 2026. “we can pay the premium for maybe a month or two while we wait and cross our fingers that legislators will vote to renew the subsidies,” she said. “If nothing changes, we will have to cancel our plan and we don’t know if there will be any option available to us.” Hill fears she may have to return to full-time work,disrupting her family’s life after twelve years of prioritizing childcare.
the situation is particularly dire for families who have already lost coverage. In southern Wisconsin, Lora, a 46-year-old stay-at-home mother of five, found her family’s insurer discontinued its plan in their county, anticipating higher costs. “We were paying zero for our premium, which was a godsend,” she said. “For the first time in my life, I was starting to get medical care.” Now uninsured since the start of January, Lora has been unable to refill medications or seek treatment for a tooth infection, resorting to home remedies. The only affordable plan available costs $200 a month, forcing her family to consider cutting back on essential expenses. “We already sell personal belongings to pay for food,” she said. “We don’t have support.”
these stories underscore the precarious position of millions of Americans as the future of ACA subsidies remains uncertain,highlighting the urgent need for a resolution to ensure continued access to affordable healthcare.
