The expiration of the Affordable Care Act’s enhanced subsidies left millions of Americans who wanted to keep their insurance in 2026 with an expensive option. Stick with their mid-tier Silver plan and pay the expensive monthly bill or downgrade to cheaper coverage.
An analysis released May 19 shows that many people have switched to plans with cheaper monthly premiums, but they must pay higher deductibles – the amount a person must pay before most insurance coverage kicks in.
The average deductible for ACA plans is projected to reach $3,786 in 2026, up more than $1,000 from a year ago, according to the health policy nonprofit KFF.
According to KFF, nearly 4 million Americans dropped their mid-tier silver plans, with a total enrollment of 9.8 million. Meanwhile, signups for lower-tier bronze plans reached 9.2 million, up nearly 2 million from a year earlier.
How many Americans will drop their ACA coverage?
It is still unknown how many Americans have dropped or have planned to drop ACA coverage, often called Obamacare.
The Centers for Medicare and Medicaid Services reported Jan. 28 that about 23 million Americans will sign up for ACA coverage in 2026, down from 24.2 million signups by January 2025.
But those figures include many people who were automatically re-enrolled. If those consumers fail to pay monthly premiums, which KFF said are projected to increase by an average of 58% in 2026 without increased subsidies, their coverage will eventually be terminated. CMS will not report those figures until later this year.
According to Weakley Consulting Group, about 86% of enrollees paid their monthly premiums in January. The consultant, which analyzed data from insurers in more than 30 states, projected that ACA enrollment this year would decline 17% to 26% from a year earlier.
KFF estimated that nearly 5 million people could drop their ACA coverage this year. KFF’s analysis was based on Wakely’s estimates and federal data.
“Coverage losses look about as people expected,” said Cynthia Cox, vice president and director of ACA programs at KFF. “Millions of people could drop ACA coverage due to lack of enhanced premium tax credit.”
However, some ACA critics say another factor may also be responsible for the enrollment decline. Conservative think tank Paragon Institute said COVID-era increased premium subsidies and lax oversight likely helped fuel millions of fraudulent signups.
Beyond ACA coverage, Americans are largely concerned about health care costs as they struggle to pay other living expenses like rising gas bills and housing costs.
In April, a Gallup poll reported that 6 in 10 Americans worry that they will not be able to cover medical costs if they suffer a serious accident or illness. Nearly half are concerned about routine costs.
Couple cuts back on restaurants, vacations to pay for Obamacare
Some people are struggling to pay for ACA insurance coverage due to very high monthly bills.
In 2025, Wisconsin resident Kelly Berry and her husband had individual bronze insurance plans that had a $7,500 deductible but were fully subsidized. This year, they pay a combined $2,300 a month for plans that have an $8,000 deductible.
Berry and her husband are self-employed and earn a little more to qualify for ACA subsidies, which remain open to people earning up to four times the federal poverty level.
Berry said she kept the bronze level plan “because I can’t find anything cheaper than this and I’m not going to go without coverage.”
But he said it’s a struggle. They have skipped landscaping expenses like removing dead bushes and trees from the yard. He has no plans for the holidays except visiting his old parents. They avoid eating out and check every grocery bill.
“There’s no easy way to get an extra $2,300 by cutting expenses,” Berry said. “Every time we pay a bill — mortgage, credit cards, health insurance premiums — we have to keep an eye on our bank accounts to make sure we have the money in the right place to cover things.”
Reporting by Ken Altker, USA TODAY. USA TODAY Network via Reuters Connect.