Despite shifting subsidies and rising premiums, 22.8 million enrollments show that consumers are still engaging, and that professional guidance matters more than ever.
As enhanced Affordable Care Act (ACA) subsidies expired at the end of 2025, headlines warned of coverage losses, premium spikes, and a marketplace on shaky ground. Much of the public conversation focused on what consumers stood to lose.
The 2026 open enrollment data tells a more grounded story.According to the Centers for Medicare & Medicaid Services, 22.8 million Americans selected marketplace coverage for 2026, including nearly 2.8 million new enrollees and close to 20 million returning consumers. While enrollment dipped slightly from the prior year's record high, the numbers point to resilience rather than retreat.
| Juan Carlos ("JC") Moreno National Sales Director for ACA AmeriLife |
For professionals working in ACA and under-65 markets — and for those whose practices extend across health, life, and retirement planning — this data matters. It reflects not only enrollment behavior, but how people respond when affordability shifts and healthcare decisions carry greater financial weight.
What enrollment resilience really signals
The expiration of enhanced premium tax credits introduced real pressure into the 2026 enrollment cycle. Many households faced higher gross premiums. Others delayed decisions amid legislative uncertainty. In some states, enrollment initially lagged behind the prior-year pace. Yet more than 22 million people still chose coverage.
That behavior suggests that consumers continue to rely on the marketplace as a primary source of health insurance, even when conditions are less favorable. Rather than disengaging, many adjusted their shopping habits, compared plans more carefully, and weighed trade-offs with greater intention.
What we're seeing is a shift in how people engage, not a step away from coverage.
For professionals, this distinction is essential. People didn't stop valuing coverage. They began asking more complex questions about cost, risk, and fit.
Affordability pressures don't eliminate the need for guidance.
There's no denying that affordability pressures intensified for 2026. Benchmark premiums rose sharply in many markets, driven by the end of enhanced subsidies and broader cost trends across the healthcare system. But premium averages rarely reflect individual reality.
Net costs vary widely based on income, household size, plan design, and geography. In response, many consumers shifted metal tiers, prioritized lower monthly premiums, or accepted different cost-sharing structures to keep coverage workable within their budgets.
When trade-offs grow more complex, professional guidance becomes more critical. People need help understanding what they're paying, what risks they're assuming, and how those choices fit into their broader financial picture.
Why this matters beyond ACA enrollment
For many professionals, ACA guidance isn't a standalone service. It's often the first or most visible financial decision people make before transitioning into Medicare, retirement planning, or broader protection conversations.
Enrollment behavior offers insight into trust. When consumers continue to engage, even under pressure, it signals confidence that coverage still serves a purpose. It also highlights the role professionals play in translating complexity into clarity.
These enrollment patterns reveal more than participation. They show whether people trust the guidance that helps them navigate change when they feel less confident in their decisions.
Shifting the conversation from fear to context
Post-subsidy discussions can quickly drift toward alarm. Premium increases make headlines. Coverage-loss projections spread fast. Without context, consumers may assume the marketplace no longer works for them. That's where professional leadership shows up.
Practical guidance helps people understand:
Rather than focusing solely on what changed, stronger conversations emphasize what remains. Marketplace plans are still available. Core affordability protections still exist. And millions continue to access coverage each year.
Here at AmeriLife, supporting ACA and under-65 distribution means equipping professionals with education, carrier access, and market insight so they can lead these conversations with facts, empathy, and confidence. Our approach reflects a broader industry reality: clear guidance leads to better decisions.
Exploring solutions without losing trust
As affordability pressures rise, conversations may naturally expand to include plan optimization, supplemental coverage, or coordination with other financial strategies. These discussions require discipline.
The ethical obligation remains unchanged. Recommendations should serve the individual's situation, not the urgency of the moment or the pressure of the cycle.
Consumers recognize when guidance is grounded in their best interest. Trust is built when options are explained honestly, limitations are acknowledged, and collaboration is introduced when it leads to better outcomes.
Responding to change with confidence and care
The 2026 enrollment period makes one thing clear: the ACA isn't disappearing. But the way people engage with it is evolving.
Professionals who succeed in this environment will be those who:
The ACA still stands tall. What matters now is whether our leadership helps people move forward with confidence in the decisions that follow.
Juan Carlos ("JC") Moreno is the National Sales Director for ACA at AmeriLife, where he focuses on expanding access, education, and support for professionals serving ACA and under-65 populations nationwide.