Federal Premium Tax Credits have been an important aspect of affordability for marketplace enrollees since the adoption of the Affordable Care Act. Premium tax credits lower the cost of private health plans available through the marketplace and are based on income and household size.
Since 2021, Enhanced Premium Tax Credits (EPTC) totaling $600 million annually in Pennsylvania alone made coverage more affordable than ever for enrollees. As a result, Pennie saw enrollment increase by 50% from 2021 to 2025. Pennie enrollment reached its highest point at half a million total enrollees in 2025. The enhanced tax credits expired at the end of 2025, and Pennie enrollees saw costs double on average to keep their plan in 2026.
One in Five Pennie Enrollees Drop Health Coverage Due to Expired Federal Tax Credits
High demand seen for quality affordable coverage during Open Enrollment Period.
Harrisburg, PA – Pennie, Pennsylvania’s official health insurance marketplace, concluded its 2026 Open Enrollment Period with enrollment totaling around 486,000 and with adverse effects from unprecedented cost increases. A doubling of premium costs caused around 85,000 Pennsylvanians to drop coverage, meaning that nearly 1 in 5 enrollees were unable to keep their health plan for 2026.
The 2026 ACA Open Enrollment Period is now officially over in every state.
For most Americans, if you missed the deadline to enroll in ACA exchange healthcare coverage, your options are pretty limited at this point...but there are some exceptions, so let's take a look.
Two things are true as of today: 2026 ACA Open Enrollment has ended...and 2026 ACA Open Enrollment is still going on (in some states).
The official Open Enrollment Period is over in 43 states...but residents of the other 7 (plus DC) still have time to enroll for coverage starting either February 1st or March 1st!
A few minutes ago I posted a press release from Pennie (Pennsylvania's state-based ACA exchange). The release mostly focuses on the upcoming final Open Enrollment Period deadline for February coverage in the Keystone State (January 31st), but it also includes a couple of depressing (if completely predictable) stats at the end:
Costs have risen by 102% for Pennie enrollees in 2026 due to the expiration of the enhanced premium tax credits. Congress has not extended these critical savings. To date, over 70,000 Pennsylvanians have dropped coverage as a result of the higher prices – nearly 1,000 a day for most of Open Enrollment. More information can be found at pennie.com/affordability.
I did indeed visit that link, where I found the following additional details (the data provided is as of January 20th...unfortunately they don't actually list the total 2026 plan selections anywhere for some reason):
A Officials urge all Pennsylvanians without health coverage to visit pennie.com to get protected during the Open Enrollment Period.
PENNSYLVANIA – January 22, 2026 – Time is running out to enroll in health coverage through Pennie for 2026. The Open Enrollment Period will close on January 31st, marking the final opportunity for Pennsylvanians to sign up for health insurance for the year ahead. Due to federal changes causing higher health plan costs, Pennie extended the Open Enrollment deadline to January 31st ensuring Pennsylvanians have additional time to review their options and secure coverage.
Pennie, the Commonwealth’s official health insurance marketplace, is currently open at pennie.com and offers high-quality coverage options for individuals and families who do not have access to other health insurance. If you or someone you know does not currently have health coverage, this is the final time to act and visit pennie.com to explore your options to get enrolled.
We're now over the hump: The initial deadline for people to enroll in ACA healthcare coverage starting on January 1st has passed in most states.
HOWEVER, there's some important caveats to this, as well as some last-minute deadline extensions in a couple of states, so let's dig in...
If you live in IDAHO, last night was the one and only Open Enrollment Period deadline.
This means that if you didn't actively select a plan for 2026, current enrollees are stuck with whatever plan Your Health Idaho automatically renewed theme into, while uninsured residents who didn't sign up by the deadline are mostly out of luck.
The exceptions to this for both categories are a) if they're members of a federally-recognized Native American tribe (or are Alaska Natives); or b) if they are (or become) eligible for Medicaid or the Children's Health Insurance Program (CHIP). All of these are eligible to enroll year-round.
IMPORTANT:Premium Alignment is NOT a substitute for making the enhanced ACA tax credits permanent. It does little to help the lowest-income folks who are still better off with Silver plans thanks to robust CSR assistance, and the benefits of it will be mediocre for those over 400% FPL if the enhanced tax credits expire.
Even for those it benefits the most (primarily those who earn between 200 - 400% FPL), it's a complement to the upgraded subsidies, not a replacement for them.
HOWEVER, it's still hugely helpful to those who know how to take advantage of it, and particularly in the states newly implementing it, it should relieve a huge portion of the pain being caused by the enhanced APTC expiring next month.
