The average ACA deductible has jumped 37%, an increase of more than $1,000 per person, from 2025 to 2026, according to a KFF analysis published May 19.
The analysis pulls from CMS and state open enrollment reports, along with KFF survey data and Wakely Consulting Group estimates.
Enhanced tax credits expired at the beginning of the year, shaking up premiums and shaping enrollment trends.
“This is the steepest increase in deductibles ever seen in this market and largely reflects the shift from silver plans with reduced deductibles for lower-income enrollees to bronze plans with very high deductibles,” the analysis said. The average deductible reached a record high of $3,786 in 2026.
Here are seven other things to know from the analysis:
1. Average monthly effectuated ACA enrollment could drop to roughly 17.5 million people in 2026, perhaps going as low as 16.5 million. This would be down from 22.3 million in 2025. In March, CMS reported that ACA enrollment was at 23.1 million in 2026, a 5% decrease from 2025. The Wall Street Journal found about 14% of ACA enrollees in 2026 did not pay their first monthly bill for January coverage.
2. A pronounced share of the sign-up dip stems from people with incomes just above the federal poverty level “subsidy cliff.” While this group made up 27% of the drop, it composed only 3% of 2025 plan selections.
3. Enrollee premium payments increased by 58% on average, going from $113 to $178 per month. KFF previously projected a 114% increase if people maintained the same plans, but many elected for higher-deductible ones instead. The KFF prediction also focused on just those receiving a tax credit, and the 58% figure represents consumers more broadly.
4. Based on percentages, plan selections declined the most in North Carolina, Ohio, West Virginia, Indiana, Delaware and Arizona.
5. The share of those getting premium tax credits was 87% in 2026 versus 92% in 2025. This was the first drop in subsidy uptake in six years.
6. The average bronze deductible in 2026 was $7,476.
7. The percentage of all ACA consumers opting for a silver cost-sharing reduction plan — available to consumers between 100% and 250% of the federal poverty level — fell to 37%, the smallest share on record. More than half of consumers selected these plans last year.
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