ACA Subsidies Expired. Open Enrollment Ended. But It Will Still Take Awhile To Register the Results.
•February 13, 2026
0
Why It Matters
The subsidy rollback threatens ACA market stability, raising premium affordability challenges and influencing future policy debates about federal and state support for health coverage.
Key Takeaways
- •Enrollment fell 1.2 million vs last year.
- •Enhanced subsidies expired Dec 31, 2025.
- •New Mexico used state funds to replace federal subsidies.
- •Higher premiums may trigger plan cancellations.
- •North Carolina enrollment dropped 22%, others varied.
Pulse Analysis
The expiration of the Biden‑era enhanced ACA subsidies marks a pivotal shift for the health insurance marketplace. After years of record‑breaking enrollment driven by lower out‑of‑pocket costs, the return to original subsidy levels has immediately tightened budgets for households earning above four times the federal poverty line. As premiums climb, many newly enrolled consumers face a stark affordability gap, prompting both individual cancellations and insurer terminations for non‑payment. This dynamic underscores the delicate balance between subsidy policy and market participation, a balance that policymakers will scrutinize as enrollment numbers solidify over the coming months.
State responses have added another layer of complexity. New Mexico uniquely allocated its own tax dollars to fully offset the federal subsidy loss, preserving enrollment growth that surged nearly 18%. Other states such as California, Colorado, Maryland, and Washington provided limited relief, while the majority saw declines, with North Carolina experiencing a 22% drop. These divergent strategies illustrate how localized fiscal capacity can mitigate—or exacerbate—the national trend, offering a real‑world laboratory for assessing the efficacy of state‑level subsidy supplements.
Looking ahead, the enrollment dip could reverberate through the broader health‑care ecosystem. Insurers may adjust pricing models, potentially raising premiums further, while policymakers grapple with the political fallout of a shrinking risk pool. The prolonged lag in finalizing enrollment figures adds uncertainty for both providers and consumers, emphasizing the need for transparent reporting and agile policy mechanisms. Stakeholders will be watching closely as Congress debates whether to reinstate or redesign premium assistance, a decision that will shape the ACA’s sustainability and its role in American health coverage for years to come.
ACA Subsidies Expired. Open Enrollment Ended. But It Will Still Take Awhile To Register the Results.
It’s February, so open enrollment for the Affordable Care Act is over. We’re getting the first glimpses of how sign-ups are shaking out after the expiration of enhanced subsidies that helped most people with their premium costs.
While more Americans enrolled than some policy analysts had expected, the number was still 1.2 million below what it was at the same time last year. And experts say it will be months until the numbers are final. The timing will depend on how many of those people who signed up for coverage actually pay their premiums and remain enrolled.
In coming weeks, “consumers may find they really can’t afford the premiums and cancel their plans, while carriers may also cancel coverage for nonpayment,” said Pat Kelly, executive director of Your Health Idaho, a state-based ACA marketplace, during a Jan. 22 call with reporters.
The drop comes after several years of record-breaking enrollment, with 24.2 million sign-ups for the 2025 enrollment year. Enrollment growth took off after enhanced subsidies — which lowered the amount most households had to pay out of their own income toward premiums and removed an upper-income cap — went into effect during the Biden administration. Lawmakers, in adopting the enhanced subsidies, set an expiration date of Dec. 31, 2025.
Congressional debate over extending those more generous subsidies was heated, even leading to the longest-ever government shutdown. Now, the subsidies are back to their original level, and people who earn more than four times the federal poverty rate (about $62,600 for an individual or $84,600 for a couple) can’t qualify for any at all.
Falling enrollment was seen in most states this year, with the biggest drop in North Carolina, where sign-ups fell by nearly 22%, federal data shows.
In a few places — including New Mexico, Texas, and Maryland, as well as the District of Columbia — the number of people selecting ACA plans increased.
The jump was largest in New Mexico, with its tally of people selecting plans up by nearly 18%. Increases were in the single digits in the other states and Washington, D.C.
New Mexico — uniquely — used its own tax dollars to fully offset the loss of the more generous federal tax subsidies for all consumers. A few other states, including California, Colorado, Maryland, and Washington, used state money to help some enrollees.
We’ll keep watching to see how this unfolds over the coming weeks.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
USE OUR CONTENT
This story can be republished for free (details).
0
Comments
Want to join the conversation?
Loading comments...