The Centers for Medicare & Medicaid Services (CMS) has released new data on the Affordable Care Act's (ACA's) open enrollment period, with sign-ups lagging the same time frame last year.
The data reflect enrollment through Jan. 15 on HealthCare.gov and state exchanges that lean on the federal platform, and Jan. 10 on other state exchanges. Jan. 15 marked the final deadline for the annual open enrollment period, with coverage kicking in Feb. 1.
The CMS said about 23 million individuals selected plans across HealthCare.gov and the state-based exchanges. That figure includes close to 3.4 million new enrollees and about 19.6 million returning individuals. By comparison, just shy of 24.2 million people enrolled for the 2025 plan year, according to previous data from the CMS.
Of the total enrollment, 15.8 million individuals selected a 2026 plan through HealthCare.gov, and 7.2 million enrolled on a state exchange, the CMS said.
The near-final enrollment numbers come as legislators continue to debate what's next for the ACA's enhanced premium tax credits, which expired Jan. 1 and led to significant premium spikes for many people who are covered through the individual market.
Democrats have favored extending the subsidies for several years while Congress works out a more long-term plan, though Republicans, including President Donald Trump, have argued against this. Instead, they've championed a plan to send the value directly to consumers through health savings accounts.
Healthcare costs are leading concern for voters, poll finds
The discussion is loud as healthcare costs and the impact of the expired subsidies weigh heavily on the minds of voters. A new survey from KFF found that a majority of people across political affiliations say that healthcare costs will affect their decisions in the midterm elections this fall.
Thirty percent of those surveyed said the decision not to extend the subsidies will have a "major impact" on their decision to vote in the midterms, while 31% said it will have a "minor impact." KFF polled a sample of 1,426 adults between Jan. 13 and Jan. 20 for the report.
More than half (54%) of Democrats said the end of the subsidies would have a major impact on their choice to vote, as did 29% of independents. Just 12% of Republicans said it would impact their decision to vote in the midterms.
In addition, 32% of those surveyed said the expiry of the subsidies would have a "major impact" on which parties' candidates they would support, and 30% said it would have a minor impact. A majority (59%) of Democrats and 30% of independents said it would have a major impact, compared to 11% of Republicans.
The poll also found that 55% of individuals said their healthcare costs have increased in the past year, with 32% saying they're very worried about affording their healthcare expenses. Thirty-four percent said they are somewhat worried about affording health costs.
"With healthcare costs topping the list of economic worries across partisans and key groups, voters expect the issue to play a major role in their decisions to turnout in November’s midterm elections as well as which candidates they support," the KFF analysts wrote in the report.