The Centers for Medicare & Medicaid Services (CMS) reported that as of January 3, 22.8 million consumers have selected 2026 individual market health insurance coverage during open enrollment. Americans have until January 15 to sign up for coverage on the federal marketplace, but some state exchanges have extended their deadlines.
The 22.8 million includes 15.6 million marketplace plan selections in the 30 states that use the HealthCare.gov platform for the 2026 plan year and 7.2 million plan selections in the 20 states and the District of Columbia with state-based exchanges that have their own eligibility and enrollment platforms.
CMS said that 2.8 million enrollees are new to the marketplace and 20 million were previously enrolled in coverage in 2025.
The totals are down by about 830,000 compared to the same time period last year, according to Jared Ortaliza, an ACA marketplace policy analyst at KFF. In addition, he said plan sign up for state-based marketplace in 2026 are two percent lower than the same time last year and selections for states that use the Healthcare.gov platform are four percent lower.
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The counts may not fully show the impact of the expiration of the enhanced premium tax credits on enrollment, Ortaliza wrote, because the data only reflects plan selections and those who were automatically renewed into 2026 coverage. As consumers receive their first premium bills and see how much they owe, they may actively disenroll or choose not to pay the premium. A complete picture of enrollment won’t be available until the summer, he said.
KFF analysts previously estimated that premiums will rise an average of 114 percent from $888 to $1,904 without an extension of the enhanced premium tax credits. Congress failed to pass an extension in 2025 but last week the House of Representatives voted in favor of legislation to retroactively renew the enhanced subsidies for three years, starting January 1. Although the Senate doesn’t have to take up the bill, a group of bipartisan senators is working on alternative legislation that includes an extension with restrictions.