If You Dropped Your Marketplace Plan This Year, Here’s What’s Actually True Right Now

Back in January, when the enhanced ACA premium tax credits expired and renewal notices started landing with much bigger numbers on them, I wrote about what changed and why. Six months later, the more useful question isn’t “what changed” — it’s “what actually happened next.” So here’s the update.

The numbers came in, and they’re not small

KFF’s latest tracking, released in May, shows average monthly Marketplace enrollment falling from about 22.3 million people in 2025 to somewhere between 16.5 and 17.5 million in 2026. That’s a drop of roughly a quarter — right in line with what the Congressional Budget Office predicted would happen once the enhanced subsidies expired.

The people most likely to have walked away aren’t who you’d guess. It’s not mostly low-income enrollees — they largely stayed, even with smaller subsidies, because they still had some help. The steepest drop-off is concentrated in two groups: people whose income sits just above 400% of the federal poverty level (the group that lost subsidy eligibility entirely — they made up just 3% of enrollment last year but account for over a quarter of this year’s decline), and younger adults, who are more likely to gamble on going without coverage when the price jumps.

If you’re one of the people who dropped coverage — here’s the part that matters

A lot of people saw the new premium, assumed it simply wasn’t affordable anymore, and let their plan lapse without checking what was actually available. Some of them were right. But some weren’t — the original ACA subsidy is still there, it’s just smaller, and pricing varies a lot by plan and by carrier. If you dropped coverage back in January or February without really shopping the alternatives, it’s worth a second look now rather than assuming nothing’s changed.

That said — outside of Open Enrollment (which runs November through mid-January), you generally can’t just re-enroll on a whim. You need a qualifying life event: losing other coverage, a change in household size, a move, a change in income that affects subsidy eligibility, and a handful of others. If you’re not sure whether you qualify for a Special Enrollment Period right now, that’s a five-minute conversation, not a research project — ask before you assume the door’s closed until January.

The politics haven’t resolved — and probably won’t soon

The House passed a three-year extension of the enhanced credits back in January. It’s been sitting in the Senate since, effectively dead on arrival with GOP leadership. There’s a bipartisan group working on a scaled-back compromise — something like a two-year extension paired with income caps and anti-fraud measures — but nothing has passed, and I wouldn’t hold my breath for action before the 2026 midterms make this even more politically loaded than it already is.

Practical takeaway: don’t wait for Congress to fix this before you make a decision about your coverage. Plan around what’s true today.

For small employers, this is still the year to pay attention

I said this back in January and it’s held up: as individual coverage gets more expensive and less predictable, more employees start looking to their employer to fill the gap. If you’re a small business owner who’s been on the fence about offering group coverage, the calculus keeps getting more one-sided. It doesn’t have to be a big, complicated build — even a modest plan changes the conversation with people you’re trying to keep.

Bottom line

If you dropped coverage, don’t assume the door’s closed — check if you qualify for a Special Enrollment Period before writing it off. If you’re still covered and haven’t looked at your options since your renewal, it’s worth five minutes to make sure you’re not overpaying relative to what’s actually out there. And if Congress moves on an extension, I’ll post an update — but I wouldn’t plan your year around it.

Questions about your specific situation — whether you still qualify for help, whether you have a qualifying event, or whether it’s finally time to look at group coverage for your business? Reach out. That’s what I’m here for.

— Mark Gurda, Castle Group Health