Exchange Coverage Remains Near Record High with 23.1 Million Enrolled in 2026

CMS Newsroom

Published March 27th, 2026

Detected March 28th, 2026

Summary

The Centers for Medicare & Medicaid Services (CMS) reported that 23.1 million consumers selected or were automatically re-enrolled in coverage through the Health Insurance Exchanges for plan year 2026. The report highlights the impact of CMS enforcement actions to prevent fraud, which resulted in the removal of nearly 1.5 million improper enrollments.

View original document View source feed page

What changed

The Centers for Medicare & Medicaid Services (CMS) has released its Health Insurance Exchanges 2026 Open Enrollment Report, detailing that 23.1 million consumers selected coverage for plan year 2026. A significant finding is the impact of CMS enforcement actions in 2025, which identified and removed nearly 1.5 million improper enrollments due to ineligibility for financial assistance or unauthorized enrollment, thereby protecting taxpayers and consumers.

This report provides data on demographics, premiums, and financial assistance, indicating shifts in plan selections with Bronze plans increasing in popularity. It also notes the program's role in expanding access to affordable coverage for low-to-moderate income individuals. Compliance officers should note the enhanced data reporting, including a six-year overview of agent-assisted enrollments and the inclusion of Health Savings Account (HSA)-eligible plan data, reflecting policy changes from the Working Families Tax Cut legislation. The report also mentions operational updates such as Illinois transitioning to a State-Based Exchange and the District of Columbia launching a Basic Health Program.

What to do next

Review the 2026 Open Enrollment Report for insights into consumer behavior and plan selection trends.
Assess the impact of CMS enforcement actions on eligibility and enrollment processes for future planning.
Incorporate new data reporting insights, such as agent-assisted enrollment trends and HSA-eligible plan data, into compliance monitoring.

Source document (simplified)

Press Releases Mar 27, 2026

Exchange Coverage Remains Near Record High as 23.1 Million Enroll in 2026, Reflecting Continued Strength and Stability

Affordable Care Act Marketplace Share

The Centers for Medicare & Medicaid Services (CMS) today released the Health Insurance Exchanges 2026 Open Enrollment Report, summarizing plan selection activity for plan year 2026 across the individual Exchanges in all 50 states and the District of Columbia. The report includes data on demographics, premiums, financial assistance, and cost sharing.

During the 2026 Open Enrollment Period (OEP), 23.1 million consumers selected or were automatically re-enrolled in coverage through HealthCare.gov and State-Based Exchanges.

Topline findings include:

Impact of CMS Enforcement Actions to Prevent Fraud : In 2025, CMS took significant enforcement action to identify and remove improper enrollments, protecting taxpayers and consumers: we ended advance payment of the premium tax credit (APTC) or coverage for nearly 1.5 million people found to be either ineligible for financial assistance, or enrolled without their authorization on the HealthCare.gov platform.
Plan Selection Trends: Plan choices shifted, with 40% of enrollees selecting Bronze plans, 43% Silver, and 17% Gold. Compared to the 2025 OEP, Bronze plan enrollment increased by 10 percentage points, Gold increased by 4 points, and Silver decreased by nearly 14 points.
Income and Affordability: Nearly half of enrollees (46%) had household incomes between 100-150% of the federal poverty level with the vast majority receiving financial assistance. This highlights the program’s role in expanding access to affordable coverage for those who need it most.
Enhanced Data: For the first time, the report includes a six-year overview of insurance agent- and broker-assisted enrollments for HealthCare.gov states. In addition, data on Health Savings Account (HSA)-eligible plan selections will be available to the public due to policy changes from the Working Families Tax Cut legislation.
Operational Updates: The report reflects Illinois’ successful transition to a State-Based Exchange for the 2026 OEP and the launch of a Basic Health Program in the District of Columbia. The full 2026 OEP Report is available at: www.cms.gov/data-research/statistics-trends-reports/marketplace-products/2026-marketplace-open-enrollment-period-public-use-files

CMS plans to release 2026 Effectuated Enrollment data later this spring.