Affordable Care Act enrollment is slightly ahead of last year, despite expiring subsidies

NEW YORK (AP) — The number of Americans signing up for Affordable Care Act health insurance for 2026 is moderately higher than it was at a similar time last year, initial new federal data shows, even as subsidies set to expire at the end of 2025 will make the coverage more expensive for many.

Seen at face value, the data from the Center for Medicare and Medicaid Services seems to defy predictions that many Americans facing pricier plans would drop out of marketplace coverage altogether next year. But experts caution that the numbers are an incomplete snapshot of total enrollment, which could still show a decline by the end of the open enrollment period.

“Overall, it’s just too early to know what any of this means,” said Jason Levitis, a senior fellow in the health policy division at the Urban Institute.

The data released Friday shows that by day 29 of the window for Americans to shop for Affordable Care Act plans this year, nearly 5.8 million people had picked one. That’s nearly 400,000 more enrollments than by day 30 of the open enrollment period last year.

Meanwhile, this year’s enrollment numbers are about 1.5 million lower than the 7.3 million or so people who had signed up 32 days into the open enrollment period two years ago, showing there is some fluctuation year to year in when people sign up for coverage.

In most states, for Americans who want coverage to start Jan. 1, the window to shop for Affordable Care Act coverage began Nov. 1 and ends Dec. 15. People who want their coverage to start later can continue to select plans through Jan. 15.

Five years ago, about 12 million people selected an Affordable Care Act plan. Enhanced tax credits were introduced the following year and four years later enrollment had doubled to over 24 million. Today, millions of people benefit from the enhanced subsidies — and if they expire as expected in the new year, the average person who receives a subsidy will see their annual premiums more than double, according to health care research nonprofit KFF.

The tax credits have been at the heart of fierce discussions in Congress in recent weeks, with Democrats insisting that they be extended to help Americans with rising health costs. The Senate is expected to vote this week on a Democratic proposal to extend the subsidies without major changes. But Republicans in charge have already rejected that proposal, and hopes for any extension are diminishing with many Republicans opposed.

Experts said there are various potential explanations for this year’s enrollment numbers tracking higher so far, including that Affordable Care Act health insurance has been prominent in the news as Congress debates a solution to the expiring subsidies.

Another factor is that older, sicker people tend to choose their health plans earlier in the enrollment period because they know they will purchase coverage regardless of the cost. Americans on the fence about canceling, meanwhile, could be considering their options or waiting to see whether Congress comes to a last-minute extension of the expiring subsidies.

Levitis of the Urban Institute noted that people may be swapping higher-tier plans for less expensive ones that have pricier deductibles and only later canceling, which could be causing a delay in the impact of the expiring subsidies on enrollment.

“All of this stuff takes a while to diffuse through the system,” he said.

Joe Antos, a health economist at the business-oriented American Enterprise Institute, said Republicans will likely try to prop up the latest data as evidence that expiring subsidies won’t have a negative impact on people being able to afford health coverage.

But “that’s not going to change what politicians in red states know,” Antos said, noting that many Republicans in vulnerable U.S. House districts are aware they could face backlash from working-class constituents next year if an extension is not reached.