Seeing the effect of higher ACA premiums

With the rise in Affordable Care Act insurance premiums (and that "subsidies that help people purchase coverage shrank or vanished"), KFF Health News reported on the drop in enrollees who paid their premiums, citing one news source as saying that "roughly 21% of people using the federal ACA marketplace ... failed to pay their share of January premiums, which, if correct, is far higher than at the same time last year." In addition to rising premiums, "the average ACA plan deductible saw the steepest increase in history — growing by 37%, or over $1,000, from $2,759 in 2025 to $3,786 in 2026 as enhanced premium tax credits expired." One consulting group "estimates that average ACA enrollment will end up being 17% to 26% lower this year than last."

With the effective premiums rising as much as they are, it is not surprising that many people choose to skip paying for insurance. Since healthier people might be more likely to forgo insurance, a drop like this can lead to higher premiums for the remaining enrollees, which could trigger spiraling prices. One consultant noted that these drops in enrollment "are real people with real consequences."