WASHINGTON, D.C. — More than 23 million Americans secured health insurance coverage for 2026 through federal and state marketplaces, as plan choices shifted and federal officials increased enforcement against fraudulent enrollments.
What This Means for You
- More than 23 million people enrolled in marketplace health plans for 2026
- Federal enforcement removed nearly 1.5 million improper enrollments
- Plan choices are shifting, with more consumers selecting lower-cost options
The Centers for Medicare & Medicaid Services reported that 23.1 million consumers either selected or were automatically re-enrolled in coverage during the 2026 Open Enrollment Period.
Health insurance marketplaces, also known as Exchanges, are government-run platforms where individuals can compare and purchase insurance plans, often with financial assistance based on income.
Enrollment and Plan Trends
CMS data shows a shift in plan selection compared to the previous year.
About 40% of enrollees selected Bronze plans, which typically have lower monthly premiums but higher out-of-pocket costs. Silver plans accounted for 43% of enrollments, while 17% chose Gold plans, which generally have higher premiums but lower costs when receiving care.
Compared to 2025, enrollment in Bronze plans increased by 10 percentage points, while Silver plan participation declined by nearly 14 points.
Income and Financial Assistance
Nearly half of enrollees — about 46% — reported household incomes between 100% and 150% of the federal poverty level.
Most of these consumers received financial assistance, often in the form of advance premium tax credits, which lower monthly insurance costs.
Enforcement Actions
Federal officials said enforcement efforts in 2025 led to the removal of nearly 1.5 million enrollments that were either unauthorized or involved individuals who did not qualify for financial assistance.
These actions included ending advance payments of premium tax credits or terminating coverage in cases where eligibility requirements were not met.
Expanded Data and System Changes
The 2026 report includes new data tracking enrollment activity assisted by insurance agents and brokers over a six-year period.
It also introduces public reporting on plans eligible for Health Savings Accounts, which allow individuals to set aside pre-tax funds for medical expenses.
State-Level Updates
Illinois transitioned to a fully state-run exchange for the 2026 enrollment period, while the District of Columbia launched a Basic Health Program, which provides low-cost coverage for eligible residents.
Next Steps
CMS said additional data on how many consumers maintain coverage throughout the year is expected to be released later this spring.
The full report is available at www.cms.gov/data-research/statistics-trends-reports/marketplace-products/2026-marketplace-open-enrollment-period-public-use-files.
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