Deductibles rose by more than $1,000 on average this year for Americans enrolled in individual health insurance coverage under the Affordable Care Act, also known as Obamacare, after the Republican-led Congress didn’t renew enhanced subsidies.
A new KFF analysis shows the average deductible jumped by more than $1,000, or 37%, to $3,786 this year from $2,759 last year as enhanced premium tax credits expired effective at the beginning of this year. KFF analysts called the deductible increase the “steepest in history” for coverage under the ACA.
Across the health insurance industry, the end of enhanced tax credits is triggering an exodus of health plan members who either can no longer afford coverage or who are buying lower-priced “bronze” plans that carry high deductibles, industry analysts and companies have said. KFF’s new report says enrollment could drop “by 21.5% or nearly five million people this year, falling from 22.3 million people in 2025 to about 17.5 million in 2026.”
The subsidies, or tax credits, made health insurance premiums more affordable for individuals and were enhanced by the Biden administration and the Democratic-controlled Congress, which passed the Inflation Reduction Act of 2022, allowing more Americans to buy coverage. The enhanced subsidies helped enrollment in Obamacare hit a record and drove its popularity to all-time highs.
The Trump administration, via the Centers for Medicare & Medicaid Services, said in late January that 23 million consumers “have signed up for 2026 individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period on November 1, 2025.”
But the Trump White House numbers were before Americans started paying their premiums. KFF said a “significant number of marketplace enrollees are expected to lose their coverage mid-year” because they failed to make monthly premium payments, which have increased by an average of 58% from $113 to $178.
For those who are continuing to buy Obamacare, the KFF analysis shows they have shifted toward “lower-premium, higher-deductible plans. “Between 2025 and 2026, sign-ups for bronze plans jumped from 30% to 40% of total plan selections—growing from 7.3 million to 9.2 million people,” KFF said.
Meanwhile, sign-ups for silver marketplace plans, which have higher premiums and lower cost-sharing than bronze plans, “hit the lowest levels in the program’s history,” KFF said.
“Silver plan sign-ups fell from 57% to a record-low 43%, dropping from 13.7 million to 9.8 million people,” KFF said. “The share of marketplace enrollees who signed up for cost-sharing reduction silver plans—which reduce out-of-pocket costs for deductibles, copayments, and coinsurance for lower income enrollees—also fell to the lowest level on record: 37%.”
Health insurers are already seeing big drops in enrollment due to higher costs. Centene, one of the biggest sellers Obamacare, said such enrollment tumbled by 2 million enrollees to 3.58 million at the end of the first quarter compared to 5.54 million at the end of last year and 5.62 million in the year ago quarter. And UnitedHealth Group’s UnitedHealthcare last month said its Obamacare enrollment was down as well, falling to 1.4 million from 1.7 million last year.
