The Centers for Medicare and Medicaid Services has reported that ACA marketplace enrollment reached a record 24 million for the 2026 plan year, driven by enhanced subsidies, Medicaid unwinding redeterminations, and expanded outreach to uninsured populations.
Enrollment Breakdown
The historic enrollment figure represents a 15% increase over the previous year and includes first-time marketplace enrollees displaced from Medicaid.
- Total marketplace enrollment: 24 million (up from 20.8 million in 2025)
- New enrollees: 6.2 million, including 2.8 million previously on Medicaid
- Average monthly premium after subsidies: $92/month
- States with highest growth: Texas (+22%), Florida (+19%), Georgia (+18%)
- 92% of enrollees receive premium subsidies
Policy Context
The record enrollment strengthens the political case for extending enhanced premium subsidies beyond their 2026 expiration. With nearly 1 in 14 Americans now covered through the marketplace, any disruption to subsidies would create significant political and healthcare system consequences.
