ACA deductibles reach record high as membership losses slated to continue: KFF – Image for illustrative purposes only (Image credits: Pixabay)
The average deductible for plans sold on the Affordable Care Act marketplaces has climbed to an all-time high of $3,786 in 2026. That figure marks a 37 percent jump from the prior year and reflects the first full year without enhanced premium subsidies. Millions of enrollees now face steeper out-of-pocket costs as a direct result of those changes.
Sharp Rise Driven by Plan Shifts
Most of the increase stems from a broad movement toward bronze-level plans, which carry lower monthly premiums but much higher deductibles. The share of enrollees in bronze plans rose from 30 percent in 2025 to 40 percent in 2026. Lower-income households that previously benefited from cost-sharing reductions on silver plans have been especially affected.
Without this widespread switch to higher-deductible coverage, the average deductible would have increased by only about 6 percent, according to the analysis. Instead, the actual jump reached more than $1,000 per person in a single year – the largest one-year change recorded since the marketplaces opened in 2014.
Enrollment Outlook Turns Negative
Marketplace enrollment is projected to fall by at least 17 percent this year, dropping to roughly 17.5 million people. The loss of enhanced subsidies has raised premiums for many households, prompting some to drop coverage altogether or seek alternatives. Early signs point to continued attrition in the months ahead.
Insurers and state regulators are monitoring the trend closely. A sustained decline could reduce the overall risk pool and place additional pressure on remaining enrollees through future rate adjustments.
Comparison of Key Figures
| Metric | 2025 | 2026 |
|---|---|---|
| Average Deductible | $2,759 | $3,786 |
| Year-over-Year Change | – | +37% ($1,027) |
| Bronze Plan Share | 30% | 40% |
What Comes Next for Consumers
Shoppers returning to the marketplaces this fall will encounter a narrower set of affordable options. Many will need to weigh higher deductibles against monthly premiums that have also risen for unsubsidized buyers. Open enrollment begins in November, giving households time to compare plans before coverage changes take effect in January.
State-based marketplaces and consumer advocates are expanding outreach efforts to help people navigate the new cost structure. The coming months will reveal how many individuals ultimately retain coverage or exit the system entirely.
