While some states have extended their deadlines, Jan. 15 is the very last day for most enrollees if they want coverage in 2026.
Early numbers from the Centers for Medicare and Medicaid suggest many people ultimately opted out of signing up, as Congress failed to reach a deal on extending enhanced premium subsidies that expired at the end of last year.
Without the enhanced subsidies, people are paying double last year's premiums on average; many were met with sticker shock when open enrollment began.
The Centers for Medicare & Medicaid Services (CMS) reported on Monday that 22.8 million consumers had signed up for 2026 individual market health insurance, about 800,000 fewer than the same time last year.
There were about 2.8 million new customers for 2026, a tumble when compared to the roughly 3.1 million new customers last year. There was also a drop in returning customers, going from 20.4 million last year to 19.9 million this year.
Some states have extended enrollment deadlines.
In Massachusetts, open enrollment ends Jan. 23 and in Virginia the deadline is the 30th. In California, D.C., New Jersey, New York, Pennsylvania and Rhode Island, open enrollment closes Jan. 31. Get Covered Illinois announced this week that its deadline would also be extended to the end of the month.
For ACA enrollees like Lori Hunt, living in Iowa's 3rd Congressional District and unemployed, the absence of the enhanced premium subsidies introduced a high degree of uncertainty into 2026. Her monthly premium went up by tenfold, and at her current income, she's not sure she'll be able to afford it every month.
Hunt was diagnosed with breast cancer three years ago and now takes tamoxifen to help prevent recurrence. She worries not only about going without this medication, but also about any unexpected medical emergencies she might have this year.
"You never know what the year is going to bring," said Hunt. "What if I trip on the stairs, you know? What if I get poison ivy in my yard — which is wicked and so I'm very sensitive to it. What if I come in contact with that again, and then have to go to urgent care?"
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