Final 2026 Open Enrollment Report: New vs. Renewals (Part 2)

Now it's time to move on to the actual demographic breakout of 2026 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollment.

First up: Breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).

Nationally, 15.6% of all exchange QHP enrollees were new this year. The other 84.4% are current enrollees who signed up for another year.

Fortunately, more enrollees took my advice and actively re-enrolled this year (46.3% vs just 39% last year). Unfortunately, 38.1% still allowed themselves to be passively auto-renewed. Those are the ones who, in many cases, were likely hit with massive sticker shock as they were auto-renewed into a plan which probably had dramatically higher premiums due to the enhanced tax credits expiring...over 8.8 million enrollees nationally.

Vermont had the lowest percent of new enrollees this year (8%), while Rhode Island had the highest at 22.6%.

As I've noted before, there's still a massive divide between federal and state-based exchanges when it comes to active renewals: Over 52% of federal exchange states actively renewed (which is good!)...but only 33% of state-based exchange enrollees did. Active renewals range from just 9% in DC to 66% in Utah.

Again, nationally, 45% of those renewing this year (38% of all enrollees) did so automatically...that is, they took no action whatsoever.

The Public Use File drills down even further on the data for 2025 enrollees who actively re-enrolled this year, breaking them down between those who switched to a different plan and those who allowed themselves to be passively re-enrolled into the same policy (or who were automatically "cross-walked" into the next closest plan in cases where their existing policy was no longer being offered).

Unfortunately this data is only available for the 30 states hosted on the federal exchange, but it's still handy info, especially this year when premiums shot up so dramatically for nearly every ACA enrollee.

For those 30 states, anyway, over 700,000 more enrollees actively selected a policy for 2026 than in 2025 even though there were 1.2 million fewer enrollees overall. This is a good thing not just because of the expired tax credits but because I always encourage people to actively shop around regardless of the subsidy situation, since there's always lots of other changes every year which can dramatically change which policy is the best value for you.

Overall, this still only amounted to around 52% of all HC.gov enrollees, but it's still better than last year when only 45% did so.

Of those who did actively re-enroll, over 5.3 million switched policies this year...64% of all active renewals, up a whopping 1.5 million people (+39%) over last year.

This means that over 1/3 of all HC.gov enrollees (33.7%) are existing enrollees who switched policies for 2026. By contrast, last year only 23% did so.