ACA Marketplace enrollments are down, but more may drop if premium not paid

The Centers for Medicare and Medicaid Services (CMS) reports that around 23 million people have signed up for an Affordable Care Act (ACA) Marketplace plan (or been automatically reenrolled) during the 2026 Open Enrollment Period as of January 15, 2026 for states using the Healthcare.gov platform and January 10, 2025 for state-based exchanges. This represents a drop of about 1.2 million consumers compared to the 24.2 million who signed up around this point in time last year, and 1.3 million fewer sign-ups than the final enrollment numbers reported at the end of Open Enrollment in 2025. ARTICLE