The deadline to enroll in Affordable Care Act coverage for 2026 is here, but Congress still hasn’t figured out what it’s doing about subsidies.
The enhanced ACA subsidies from the Biden era have now expired, and without a replacement, premiums are expected to jump meaningfully. That’s creating a massive policy mess, because if lawmakers reach a deal after the deadline, it may be too late to fully undo the damage. Many people may have already skipped coverage entirely.
Fewer Americans are signing up
Enrollment is already sliding. About 22.8 million people were enrolled in ACA plans as of January 3, down from 24.3 million in 2025, according to CMS.
That drop is smaller than what the Congressional Budget Office expected, but the bigger fear is what happens next: even if people enroll, many could drop coverage later in the year once they see the new premium bills.
Markets are paying attention
Stocks tied closely to ACA Marketplace plans dipped around the deadline, including:
Oscar Health $OSCR ( ▲ 4.37% )
Molina Healthcare $MOH ( ▲ 2.57% )
Centene $CNC ( ▲ 2.38% )
UnitedHealth $UNH ( ▲ 1.19% )
Investors are basically trying to price the same question lawmakers can’t answer yet: how many people will stay covered if subsidies don’t return.
The political trap for Republicans
This is also turning into a political liability. ACA enrollees disproportionately live in Republican districts and states, which makes this one of those rare issues where the base of a party can end up getting hit hardest by its own internal gridlock.
Moderate House Republicans joined Democrats to pass a three-year extension of the tax credits, but that bill failed in the Senate, and now lawmakers are scrambling to negotiate a replacement.