Enrollment in the Affordable Care Act (ACA) Marketplaces fell in 2026 for the first time in seven years, following the expiration of the enhanced premium tax credits at the end of 2025. Changes in enrollment, however, were not evenly distributed across the country. Marketplace enrollment changed substantially from one state to another, and even within states. This analysis estimates how Marketplace enrollment varies both within and across states using both publicly available data on federally facilitated Exchanges (FFEs) from the Centers for Medicare and Medicaid Services (CMS) and data provided by state-based Exchanges (SBEs).
How Does ACA Marketplace Enrollment in 2026 Vary Across Congressional Districts?
