New York Sees Decline in ACA Enrollment Amid Rising Premiums

Fewer New Yorkers are enrolling in private health insurance plans through the state’s Affordable Care Act (ACA) marketplace as insurance premiums continue to rise. Early data indicates that as of January 1, 2026, approximately 206,427 individuals had signed up for private insurance, reflecting a 3% decrease compared to the same period last year. This trend aligns with findings from the health policy nonprofit KFF, which also reported similar declines in ACA enrollment across various states.

Despite the downturn in private plan enrollment, overall health coverage in New York is not declining significantly. The state’s Essential Plan, a publicly funded insurance option catering to lower-income residents, has seen a rise in enrollment. As of early January, participation in the Essential Plan increased by 6% compared to the previous year, indicating a shift in preference among some consumers.

Concerns Over Premium Increases

According to Danielle DeSouza, a spokesperson for the New York State Department of Health, enrollment in the marketplace was “trending significantly lower” before the December 15 deadline for coverage starting January 1. However, late sign-ups helped to close the gap somewhat. New Yorkers still have until the end of January to enroll for plans that commence this year. DeSouza expressed concern that some individuals facing high insurance costs may decide to forgo their plans once premium payments are due.

One such individual, Rebecca Boyden, a competitive figure skating coach from Queens, shared her experience with the rising costs. She enrolled in a marketplace plan to meet the deadline but is reconsidering her options. Previously, her highest premium was around $350 per month, but this year she is signed up for a Bronze-level plan costing $686 monthly. Boyden is evaluating her budget to determine which expenses she can cut to afford health insurance, stating, “How much can I stomach not having health insurance at all?”

Impact of Expired Federal Subsidies

The decline in enrollment and rising premiums can be partly attributed to the expiration of enhanced federal insurance subsidies at the end of 2025. These subsidies had significantly lowered costs for many, but their expiration has resulted in reduced eligibility for financial assistance and diminished support for those still qualifying. State officials estimate that approximately 140,000 New Yorkers who benefited from these subsidies will see an average increase of $114 in their monthly premiums, totaling nearly $1,400 additional expense over the year.

DeSouza noted that premiums have spiked by approximately 40% this year, which raises concerns about affordability and access to health care for many residents. The combination of rising costs and reduced support could lead to further declines in enrollment as individuals weigh their options in a challenging economic landscape.

As New Yorkers navigate this complex situation, the future of health coverage in the state remains uncertain, with officials closely monitoring enrollment trends and payment behaviors in the coming months.