ACA enrollment is collapsing in real time. Georgia just saw a 28% drop in premium payments in a single month.
The enhanced subsidies that kept ACA premiums affordable expired at the end of 2025. Here's what happened next:
- Average premiums jumped 26% in 2026
- Average deductibles grew 37%, from $2,759 to $3,786, the steepest single-year increase ever recorded
- 21% of federal marketplace enrollees failed to pay their January premiums
- Georgia saw a 28% drop in premium payments in April vs April 2025
- New Jersey hit an 11.6% payment failure rate
- Wakely Consulting Group estimates total 2026 enrollment will end up 17% to 26% lower than 2025
The people who didn't drop coverage entirely mostly downgraded. Bronze plan enrollment jumped from 30% to 40% of all selections, which means millions of people are now technically insured but carrying $3,786 deductibles they likely can't afford to use.
New Mexico is the only state that actually held the line, they used state funds to cover the subsidy gap themselves.
The 2027 rates aren't finalized yet but analysts aren't expecting things to improve. Insurers are pricing in ongoing enrollment decline and uncertainty, which tends to push premiums higher, which pushes more people out, which pushes premiums higher again.
How bad does this have to get before it becomes a political emergency?