Enrollment in the individual market fell 18% between June 2025 and June 2026, a drop of more than 4.6 million people, according to an Oct. 14 KFF analysis.
Looking at comparable periods in previous years, enrollment has generally increased, growing 7% between June 2024 and June 2025. However, the declines have been present through much of 2026, with the composite individual market enrollment falling 16% year over year in March.
Drops in individual enrollment started during the 2026 open enrollment period. While plan selections during the period dropped by 1.2 million people from 2025, this does not reflect people who sign up but do not pay premiums. There is a three-month grace period for returning subsidized enrollees. February ACA marketplace effectuated enrollment, determined after the grace period, dropped by 12% year over year, from 21.8 million to 19.2 million.
While the individual market also includes off-exchange enrollment, much of individual coverage is bought on exchange through ACA marketplaces. The expiration of enhanced tax credits going into 2026 has shaped ACA marketplace affordability, spurring concerns of people dropping coverage.
Higher marketplace premiums could be another challenge to maintaining enrollment. States have been finalizing ACA rate changes, and KFF previously reported that payers requested a median rate increase of 15% for 2027.
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