Eroding ACA enrollment portends higher insurance rates

HealthWatch Eroding ACA enrollment portends higher insurance rates .chip { background-image: url('/fly/bundles/cbsnewscore/images/chip-bgd/chip-bgd-healthwatch.jpg'); } By Julie Appleby May 19, 2026 / 5:00 AM EDT / KFF Health News Add CBS News on Google Enrollment in the Affordable Care Act continues to erode as some customers struggle to make premium payments, with the declining numbers churning market uncertainty for insurers. In response, insurers are likely to raise rates again next year, following this year's larger-than-typical hikes.Sign-ups were already down in January by about 1.2 million from last year's record enrollment. For this year, enrollees then faced premiums that increased, on average, by 26%. On top of that, subsidies that help people purchase coverage shrank or vanished.Now experts are watching how many of the approximately 23 million people who enrolled will fail to pay their share of premiums.While available data on premium payments is mainly from January, a few states that run their own ACA markets have released information for later months. The sharpest drop in people paying premiums, based on limited data, is in Georgia, which saw a 28% drop in April compared with the same period a year ago, according to an analysis by Charles Gaba, a healthcare policy analyst and blogger who specializes in the ACA.The news website NOTUS reported May 12 that it had internal Centers for Medicare & Medicaid Services data showing that roughly 21% of people using the federal ACA marketplace — 30 states — failed to pay their share of January premiums, which, if correct, is far higher than at the same time last year.CMS did not answer questions from KFF Health News about the enrollment data.In looking at the early numbers analysts released, "we can't yet quantify how much worse it will be than in previous years, but it will absolutely be worse because of the sticker shock," said Ellen Montz, a managing director with consulting firm Manatt Health,...