ACA sign-ups during the open enrollment period for 2026 were down 5% year over year, the most substantial dip since marketplaces launched in 2014 — but that’s not even the full story.
The Commonwealth Fund reviewed CMS and state marketplace data to evaluate trends, including changes as enrollees faced payment deadlines after open enrollment. Researchers published their findings June 8.
Here are five things to know about ACA enrollment:
- The Commonwealth Fund compared enrollment changes from a sample of states: Arkansas, Colorado, Maryland, Massachusetts, New Mexico and New York. All six saw steeper enrollment drops between the open enrollment window and April. Arkansas was hit the hardest, losing 16.2% of marketplace members.
- Out of those six states, only New Mexico and New York saw a slight boost between open enrollment and April last year. This year, both of their enrollments declined, albeit less substantially than the other states.
- Looking at broader CMS data, the share of enrollees opting for bronze plans was 39.6% in 2026 versus 29.9% in 2025.
- There was a modest boost in the percentage of gold plan selections, but silver selections dropped from 56.2% to 42.6% year over year.
- Platinum and catastrophic plan enrollment percentages did not change much and together totaled less than 1% of enrollment each year.
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
