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After ACA subsidy lapse, consumers opt for low-cost Marketplace plans

The number of patients selecting low-cost, high-deductible ACA marketplace plans rose from 30% to 40% for the 2026 Open Enrollment Period.

Silver plans are out and Bronze plans are in, according to new CMS data about the 2026 Open Enrollment Period for the Affordable Care Act Marketplace Exchanges, signaling growing consumer preference for low-cost health plans with potential for higher deductibles.

This trend could be a harbinger of what's to come, as consumers contend with higher health plan premiums and rising costs after the agency's elimination of ACA tax subsidies.

Silver plans, the mid-tier health plans sold on the ACA exchanges, have typically been the most common choice for consumers. With Silver plans, the healthcare payer covers more costs for the patient, leaving individuals on the hook for fewer out-of-pocket costs. Silver plans also tend to have moderate deductibles.

Enrollment in Silver plans during the 2026 Open Enrollment Period came out to 43%, more than 10 percentage points lower than in 2025 (56%). Notably, Silver plans used to be the default plan for individuals shopping for insurance on the Exchanges.

But not this year.

Although Silver plans were still the most popular plan on the exchanges, the data marks a shift in the types of plans consumers select. Notably, 40% of consumers opted for a Bronze plan this year, up 10 percentage points from 2025.

Bronze plans are high-deductible health plans with lower premiums. Although there are fewer up-front costs associated with Bronze plans, people with this type of insurance are liable for higher out-of-pocket costs if they need healthcare.

Patients opt for lower premiums as plan costs rise

The shift in consumer preferences could be the result of changes in the ACA Health Insurance Exchanges overall.

For the 2026 Open Enrollment Period, consumers were no longer eligible for enhanced tax subsidies designed to make health plans less expensive for qualifying individuals. Lawmakers said the subsidies came with high taxpayer costs and were rife with fraud. Still, separate analyses indicated that the lapse of subsidies would spike the cost of health plans for millions.

This latest data from CMS indicates that may have been what happened, as consumers flock to lower-cost plans with new health savings account benefits attached.

Moreover, the analysis showed that fewer people enrolled in an ACA plan at all this year compared to last year. In 2026, there were 23 million sign-ups for ACA Marketplace coverage, down from 24.3 million in 2025. Although 2026 represents the second-highest signups in ACA Marketplace history, this trend could be a bellwether of what's to come if health plan costs remain high.

Sara Heath has reported news related to patient engagement and health equity since 2015.

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