Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and therefore dropped coverage.

Prices in the market skyrocketed after President Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.

The report says 19.2 million people are currently enrolled in ACA insurance now.

At its high, 24.2 million people were in the ACA marketplace in 2025, according to government figures.

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The higher health insurance costs are tough for consumers in an economy still plagued by overall inflation. As congress let the prices go up, people made tough decisions about family budgets, where to work, whom to marry and more.

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It's also a problem for insurance companies, several of which have announced they will not be participating in ACA markets next year, including Cigna.