The Affordable Care Act (ACA) health insurance marketplace experienced a noticeable shift during the 2026 open enrollment period, with fewer consumers selecting plans while the cost of coverage increased. According to a recent ValuePenguin analysis of federal enrollment data, marketplace plan selections fell from 24.3 million in 2025 to 23.1 million in 2026, which was a decline of 1.2 million, or 4.9%.
The Expiration of Federal Tax Credits’ Domino Effect
At the same time, the average monthly premium before financial assistance increased significantly. Nationwide, the average premium rose from $619 in 2025 to $741 in 2026, representing a 19.7% increase. The size of the increase varied considerably by state. Arkansas experienced the largest percentage increase, at 42%, while West Virginia had the highest average monthly premium at $1,314.
In the ValuePenguin analysis, health insurance expert Cate Deventer offered insight into the increase of cost: “The biggest factor is plan costs, specifically the loss of the enhanced premium tax credits,” she explained. “These extra discounts had been in place since 2021 and allowed more people access to financial help. With the rollback of the extra discounts, fewer people get financial aid. At the same time, the underlying cost of a plan also increased. The combination of higher rates and fewer discounts makes it hard for some people to afford a plan.”
There were a few exceptions to the increase. Average monthly premiums fell in just two states: Alaska (5.6%) and South Dakota (1.0%). In 2026, monthly average premiums were lowest in Idaho($605,) Maryland ($542) and New Hampshire ($553).
Over 22 million Americans had claimed the premium tax credits, and their expiration hit hard for many families who relied heavily on those discounts. Those 22 million accounted for roughly 92% of the ACA Marketplace enrollees and encompassed a wide range of Americans, from small business owners to early retirees.
What’s Next in 2027?
Of the 276 insurers that participate in the ACA Marketplace, the 2027 proposed increases range from -1% to 54%. Nearly 63% of participating insurers have proposed increases ranging from 10-25% in premium costs. While these numbers are proposed rate changes, they paint a grim picture for families who are trying to get by and may find themselves choosing between purchasing health insurance and providing essentials for their families.
America’s HealthShare Is Here for You
At America’s HealthShare, we are committed to providing our members and their families with affordable healthcare. We believe that families should not have to choose between providing their loved ones with quality medical care and covering essential household expenses.
For more information about how you can join the America’s HealthShare community, please check pricing online or give our Member Care team a call today at (580) AMERI-HS.
