New York — Thursday was the final day to choose a health insurance plan for the Affordable Care Act in much of the country, as the expiration of federal subsidies drives up health care costs and lawmakers remain engaged in a debate over how to address the issue.
That’s when the open enrollment window ends in most states for plans that begin in February. About 10 states that operate their own markets have later deadlines, or have extended them until the end of the month to give their residents more time.
This date is crucial for millions of small business owners, gig workers, farmers, ranchers and others who don’t get their health insurance from a job and thus rely on marketplace plans. 24 million Americans purchased health plans under the Affordable Care Act last year.
But this year, their decisions about health coverage have been more difficult than usual, as it’s difficult to get clarity on the cost of coverage. So far, enrollment still lags behind last year’s numbers — with about 22.8 million Americans enrolled so far, according to federal data.
Nationally, about 800,000 fewer people chose plans compared to the same period last year, representing a 3.5% decline in total enrollment year to date. This includes a decline in the number of new consumers signing up for ACA plans and current enrollees re-enrolling.
Last year, for months, it was unclear whether Congress would allow expanded coronavirus-era subsidies that offset costs for more than 90% of enrollees to expire at the end of the year. Democrats were forced to shut down the government for a record period over the issue, but they are still unable to reach an agreement. So the subsidy ended Jan. 1, leaving the average subsidized enrollee with more than double their monthly premium costs for 2026, according to an analysis by the health care nonprofit KFF.
However, the question of whether Congress will revive the tax breaks looms over Washington. Many registrants told The Associated Press they have either delayed signing up for coverage or signed up for a plan to cancel as they anxiously watch what is happening on Capitol Hill.
Last week, the House approved a three-year extension of the benefits after 17 Republicans joined Democrats against the wishes of Republican leaders. But the Senate rejected a similar bill last year.
Sen. Bernie Moreno, R-Ohio, is leading a bipartisan group of 12 senators trying to reach a compromise, and he said this week he expects to have a proposal by the end of the month. Features of the senators’ bipartisan plan include a two-year deal that would extend enhanced benefits while adding new limits on who can get them. The proposal would also create an option, in the second year, for a new health savings account favored by President Donald Trump and Republicans.
Under the deal being discussed, the ACA’s open enrollment period would be extended until March 1 of this year to allow people more time to figure out their coverage plans after the filibuster.
However, Republicans and Democrats say they are not finished with the plan, and the two sides have not yet agreed on whether there should be new restrictions on whether states can use separate funds to cover abortions.
President Donald Trump on Thursday announced the outlines of a plan he wants Congress to consider. It would, among other things, redirect primary health care subsidies to health savings accounts that go directly to consumers. Democrats have largely rejected the idea as insufficient to offset the health costs borne by most people.
Copyright © 2026 The Associated Press. All rights reserved.