ACA marketplace shoppers face higher deductibles after subsidies expired

ACA Marketplace coverage is still drawing millions of people, but the shopping experience changed in 2026. CMS says 23.1 million consumers selected or were automatically re-enrolled in Marketplace plans for the year, yet the plan mix shifted after enhanced premium tax credits expired.

For many households, the biggest change is not just the monthly premium. It is also the deductible and other out-of-pocket costs that can make coverage harder to use when care is needed.

What changed for 2026

CMS reported that bronze plan enrollment rose while silver plan enrollment fell compared with 2025. The agency also said fewer consumers selected plans with cost-sharing reductions, which are the extra savings available in many silver plans for people who qualify based on income.

KFF’s latest analysis found that the average Marketplace deductible rose sharply in 2026, reflecting a broader shift toward higher-deductible plans after enhanced tax credits expired. In plain terms: some shoppers may still have coverage, but it may protect them less before they have to pay out of pocket.

Who may feel it most

The pressure is likely to be strongest for people who lost the extra premium help that had been available through 2025. Those households may face higher monthly premiums and may respond by choosing lower-premium, higher-deductible plans.

Lower-income enrollees can still qualify for financial help, but they may also be affected if a cheaper plan comes with a larger deductible, narrower network, or higher costs for prescriptions and specialist visits. As always, the exact impact depends on the plan, the state, and household income.

What CMS changed next

CMS also finalized new Marketplace rules on May 15, 2026, for plan year 2027. The agency said the rule restores pre-enrollment verification for certain special enrollment periods, requires additional income documentation in some cases, and adds safeguards intended to reduce improper enrollments and limit subsidies to eligible people.

CMS said the rule also gives states more flexibility in Exchange operations and changes some cost-sharing parameters for bronze and catastrophic plans.

What readers should check

If you buy coverage through the Marketplace, it is worth reviewing five items before the next enrollment decision or coverage change:

Your current household income estimate.
Whether you still qualify for a premium tax credit.
The plan deductible and maximum out-of-pocket limit.
Whether your doctors, hospitals, and prescriptions are in network.
Whether a special enrollment period applies if your circumstances changed.

People who expect frequent care or expensive prescriptions may want to pay close attention to deductibles and drug coverage, not just the monthly premium. People with a qualifying life event should also check the timing rules for special enrollment, since verification standards have changed.

Bottom line

Marketplace coverage remains a major source of insurance in the United States, but it is less affordable for many shoppers than it was when enhanced subsidies were still in place. The result is a more complicated tradeoff: some people may still find coverage, but they may have to accept higher monthly costs, higher deductibles, or both.

Sources

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