Health · Healthcare & Policy · 12 hrs ago
ACA enrollment opens as higher premiums and new checks loom
Enrollment for 2027 Affordable Care Act coverage opens on Nov.
1 in most states, with the sign-up period generally running through Jan.
15.
The ACA marketplace provides health insurance to people buying coverage outside employer plans, and millions enrolled in it have faced higher costs since enhanced subsidies expired at the end of 2025.
Enrollment fell to 19.2 million by February, down 2.6 million from the same time a year earlier, and further declines have been reported.
Premiums are expected to rise again, making coverage harder to afford for people already dealing with higher living costs.
New identity checks will affect some shoppers using brokers through the federal marketplace, which serves 29 states; state-run exchanges have separate rules.
These checks are intended to prevent fraud, but could slow enrollment, and some consumers may need to verify their identity before authorizing an agent.
Shoppers can enroll or look for coverage through Jan.
15 in most states, though the available plans and costs will vary.
Enrollment in Affordable Care Act plans has fallen as open enrollment for 2027 coverage begins in most states.
Federal data showed 19.2 million people enrolled as of February, 2.6 million fewer than a year earlier.
The end of enhanced premium subsidies at the start of 2026 left many people facing higher costs and dropping coverage.
The Trump administration has credited efforts to reduce fraud for the decline, while policy experts point to lost subsidies and affordability pressures.
Open enrollment began November 1 in most states, and premiums are expected to rise again.
- Who
- People buying Affordable Care Act health insurance, including millions who have left coverage.
- What
- Enrollment has fallen as sign-ups open for 2027 coverage.
- When
- Open enrollment began November 1, 2026, in most states.
- Where
- The United States; enrollment takes place through federal and state marketplaces.
- Why
- Enhanced premium subsidies expired at the start of 2026, increasing costs. The Trump administration also cites efforts to reduce fraud.
Policy experts
Trump administration
Cause of falling enrollment
Policy experts
The expiration of enhanced subsidies and higher premiums have led people to drop or lose coverage.
Trump administration
The administration credits its efforts to reduce fraud, including cancelling policies suspected of improper enrollment.
Enhanced premium subsidies expired.
Federal data showed 19.2 million people enrolled, down 2.6 million from the same time a year earlier.
Holly Hendricks became uninsured after she could no longer afford her premiums.
Hendricks developed sepsis and spent a month in hospital.
Open enrollment for 2027 coverage began in most states.
- February 2026 enrollment
- 19.2 million people
- Year-over-year enrollment change
- Down 2.6 million as of February
- Enhanced subsidies
- Expired at the end of 2025
- Premiums for Hendricks
- Nearly $1,100 a month
- Mississippi enrollment
- Around 125,000 residents in September, according to the state’s insurance commissioner
3 sources
What people are saying
Being insured is catastrophic to my health, but when you have to choose between rent, utilities, food and insurance – the more basic needs have to come first
People who tried to make it work at the beginning of the year might not be able to make it work for a whole year
that up to 1 in 5 consumers is going to have to do extra identity proofing