By Stacey Pogue and Sabrina Corlette
Congress’s failure to extend premium tax credit enhancements led to unprecedented net premium increases in Affordable Care Act (ACA) marketplaces in 2026. As a result, fewer people signed up for coverage during the 2026 open enrollment period, and many others “bought down” to less expensive plans that carry higher out-of-pocket costs. However, to more fully understand the impact of federal ACA policy changes, it’s important to look at what consumers did after open enrollment ended.
In a new blog post for the Commonwealth Fund, CHIR’s Stacey Pogue and Sabrina Corlette examine emerging state marketplace data showing that enrollment has continued to decline, with more dramatic drop-offs in coverage once premiums came due.
You can read the full blog post here.