New Delhi, May 19 -- Average monthly enrollment in the Affordable Care Act (ACA) Marketplace is expected to decline sharply in 2026 following the expiration of enhanced federal premium tax credits that had helped drive record coverage levels in recent years.

According to estimates based on data from the Wakely Consulting Group and federal Marketplace reports, average effectuated enrollment - referring to consumers who actually pay premiums and maintain active coverage - could fall to around 17.5 million in 2026, down from 22.3 million in 2025. In a worst-case scenario, enrollment could decline to as low as 16.5 million.

That would amount to a drop of between 17% and 26%, or roughly 3.8 million to 5.8 million fewer insured Americans comp...