Sen. James Lankford, Republican of Oklahoma, discusses the ongoing health care debate in the Senate and criticizes Democrats’ approach to Obamacare subsidies at Kudlow.
Registration for Obamacare plans appears trending toward decline by more than 1 million Americans in 2026 amid rising monthly premiums and the expiration of enhanced federal health insurance premium subsidies implemented during the COVID-19 pandemic.
The Centers for Medicare and Medicaid Services (CMS) released a report Wednesday showing that 23 million consumers signed up for individual health insurance coverage through the marketplaces during the 2026 open enrollment period. This included 15.8 million selections in states using the HealthCare.gov platform and 7.2 million using state-based exchanges.
Enhanced subsidies for health insurance in the COVID era expired late last year after Congress failed to reach agreement on an extension, although the original subsidies implemented under the Affordable Care Act remain in effect. The total cost of premiums for subsidized Obamacare enrollees is expected to increase by an average of $888 for 2026 to $1,904, according to KFF data.
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An analysis by healthcare industry research firm KFF found that as of mid-January, enrollment was down about 1.2 million consumers compared to the 24.2 million who signed up at this point last year.
Congress failed to reach an agreement to extend enhanced COVID-era subsidies for Obamacare plans. (Anna Moneymaker/Getty Images)
KFF noted that the enrollment data released at this point represents automatic renewals and plan selections, which do not necessarily translate into actual enrollments, as some may ultimately choose not to pay for their plan.
More than four in 10 signups in 2025 came from automatic renewals, and KFF explained that as returning consumers get their first insurer invoices and see the cost, they can choose not to pay the premium and possibly lose their coverage or choose to opt out.
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Health insurance costs are expected to increase in 2026. (Getty Images)
The group warned that without improved premium tax credits, the rate of premium completion or payment could fall compared to previous years, which could result in the bottom line registration data showing a deeper decline.
KFF conducted a survey that indicated premium payments are expected to more than double on average in 2026, and about 25% of enrollees said they would forgo health insurance this year if their premiums doubled as expected.
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Obamacare enrollment numbers won’t be finalized until the 90-day grace period for paying premiums expires. (Matt McClain/The Washington Post via Getty Images)
Analysts said they expect overall enrollment in Obamacare plans to decline in coming months as consumers see higher premiums and choose to let their coverage lapse rather than pay significantly more to maintain their coverage.
“Given the 90-day grace period, which is expected to apply to the majority of ACA members, we see the potential for high deregistration activity during this period, leading to lower final enrollment numbers,” said Elizabeth Anderson, an analyst at Evercore ISI.
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Registration on HealthCare.gov runs through January 15, 2026, although registration deadlines for state-based exchanges vary.
Reuters contributed to this report.
