Affordable Care Act Deductibles Surge 37% as Enhanced Tax Credits Expire

ACA Marketplace deductibles surged 37% from $2,759 in 2025 to $3,786 in 2026, the steepest increase in history, following the expiration of enhanced premium tax credits at the end of 2025. Premiums rose an average 26% in 2026. Bronze plan enrollments jumped from 7.3 million to 9.2 million as consumers shifted to cheaper, higher-deductible coverage. Approximately 23 million people enrolled for 2026.

ACA enrollment decline

• ▪Wakely Consulting Group estimates that average Affordable Care Act enrollment will be 17% to 26% lower in 2026 than in 2025
• ▪Affordable Care Act signups were down in January 2026 by about 1.2 million from the previous year's record enrollment
• ▪Approximately 23 million people enrolled in the Affordable Care Act for 2026
• ▪The Trump administration ended a special enrollment program that let low-income people enroll in the Affordable Care Act year-round

Premium payment failures

• ▪Georgia saw a 28% drop in Affordable Care Act premium payments in April 2026 compared with April 2025
• ▪States that run their own Affordable Care Act exchanges had a 92% premium payment rate in January 2026, compared to 82% to 84% for states served by the federal marketplace
• ▪An average 86% of Affordable Care Act enrollees made their first premium payment in January 2026, according to Wakely Consulting Group analysis of data from 75 insurers
• ▪Washington state had a 15.7% Affordable Care Act premium payment failure rate as of February 2026
• ▪New Jersey had an 11.6% Affordable Care Act premium payment failure rate as of April 2026

Deductible increases

• ▪Bronze-level Affordable Care Act plan enrollments grew from 7.3 million in 2025 to 9.2 million in 2026
• ▪The 37% increase in average Affordable Care Act plan deductibles from 2025 to 2026 was the steepest increase in history
• ▪The average Affordable Care Act plan deductible increased by 37%, or over $1,000, from $2,759 in 2025 to $3,786 in 2026
• ▪Affordable Care Act enrollees faced premiums that increased, on average, by 26% in 2026
• ▪Sign-ups for bronze-level Affordable Care Act plans jumped from 30% to 40% of total plan selections between 2025 and 2026

Political implications

• ▪Enhanced Affordable Care Act subsidies had been in place since 2021
• ▪The One Big Beautiful Bill Act was cited among factors fueling higher Affordable Care Act premiums in 2026
• ▪Enhanced Affordable Care Act premium tax credits expired at the end of 2025

Insurer rate projections

• ▪The Trump administration's finalized 2027 Affordable Care Act regulation allows for higher annual deductibles in some types of coverage
• ▪The Trump administration's initial 2027 Affordable Care Act proposal came out in mid-February 2026 and was not finalized until May 15, 2026
• ▪Michelle Anderson of Wakely Consulting Group does not expect an average 26% Affordable Care Act premium increase for 2027 like the one seen in 2026