ACA Marketplace Deductibles Rose $1,000 in 2026: What KFF’s Data Shows
The average ACA Marketplace deductible grew by 37% in 2026, from $2,759 in 2025 to $3,786, an increase of more than $1,000 per person and the steepest single-year deductible increase in the Marketplace’s history, according to a KFF analysis published May 19, 2026.
That number reflects something more complicated than plans simply getting worse. The increase did not happen because ACA insurance became dramatically less generous across the board. It happened because millions of Americans were priced out of more comprehensive coverage when enhanced premium tax credits expired and shifted to cheaper Bronze plans with much higher deductibles. The result is a Marketplace where more people technically have insurance but face significantly higher costs before that insurance pays anything. This post explains what the KFF data actually shows, what it means for people buying their own coverage, and what the full picture looks like when you combine rising deductibles with rising premiums.
What does the KFF data actually show?
KFF’s May 2026 analysis draws on CMS and state-based Marketplace open enrollment reports, KFF survey data, and enrollment estimates from Wakely Consulting Group. Together these data sources document a historic market disruption driven by the expiration of enhanced premium tax credits at the end of 2025.
The key findings:
Deductibles: The average Marketplace deductible rose from $2,759 in 2025 to $3,786 in 2026, a 37% increase and the steepest in the Marketplace’s history. For Silver plans specifically, the average deductible is $5,304. For Bronze plans it is $7,186, according to the Peterson-KFF Health System Tracker.
Plan tier shift: The share of enrollees selecting Bronze plans jumped from 30% (7.3 million people) in 2025 to 40% (9.2 million people) in 2026. Silver plan selection fell from 57% (13.7 million) to 43% (9.8 million), a record low and the first time fewer than half of all ACA consumers have selected a Silver plan. Gold plan enrollment rose slightly, from 3.2 million to 4.0 million.
Premiums: Average monthly premium payments rose 58%, from $113 to $178 per month. KFF had projected a 114% increase for people who kept the same plan, but the actual 58% figure is lower because many consumers switched to cheaper plans rather than paying the higher premium for their existing coverage.
Enrollment: About 23.1 million people signed up for Marketplace plans during the 2026 Open Enrollment Period, a decline of more than 1 million from 2025 and the sharpest single-year drop since the ACA Marketplaces launched. KFF projects that average effectuated enrollment, meaning people who have actually paid their premiums, could fall as low as 17.5 million for 2026, down from 22.3 million in 2025.
Non-payment: About 86% of January 2026 enrollees paid their first monthly premium, down from over 90% in 2025, according to Wakely Consulting Group analysis. A KFF survey found that 9% of 2025 Marketplace enrollees had already become uninsured by early 2026, and one in six returning enrollees said they were not confident they could afford coverage for the full year.
Why did deductibles increase so much?
The deductible increase is almost entirely a function of the plan tier shift rather than any change in how ACA plans are structured. KFF describes the dynamic directly: “this is the steepest increase in deductibles ever seen in this market and largely reflects the shift from silver plans with reduced deductibles for lower-income enrollees to bronze plans with very high deductibles.”
When enhanced premium tax credits were in effect through 2025, lower-income enrollees could access Silver plans with Cost-Sharing Reductions that lowered their deductibles to $500 to $1,500, sometimes lower. Those CSR-enhanced Silver plans are only available to people who qualify for them on income, so when many of those enrollees could no longer afford Silver plan premiums without the enhanced credit, they moved to Bronze plans. Bronze plans have lower monthly premiums but much higher deductibles, typically $5,000 to $10,000 or more. For someone who had a $500 deductible on a CSR-enhanced Silver plan in 2025 and now has a $7,186 average Bronze plan deductible in 2026, the effective change in their healthcare costs is far larger than the premium comparison alone would suggest.
The people who drove this shift are also the people with the least financial cushion to absorb it. KFF’s enrollment analysis found that the group most disproportionately affected was people with incomes just above the federal poverty level at the 400% subsidy cliff, who accounted for 27% of the enrollment drop despite making up only 3% of 2025 plan selections.
What does this mean in practical terms for someone buying their own coverage?
The combined effect of higher premiums and higher deductibles means that the total cost of using ACA coverage in 2026 is substantially higher than in 2025 for most individual market buyers, particularly those who switched to Bronze plans.
Consider a real scenario. An enrollee who paid $113 a month and had a $1,000 deductible in 2025 on a CSR-enhanced Silver plan may now be paying $178 a month and facing a $7,186 Bronze plan deductible in 2026. Their monthly premium increased by $65. But their exposure before insurance covers anything has increased by more than $6,000. If that person has a significant medical event in 2026, the difference in their actual financial position is dramatic and not captured at all by looking at premiums alone.
This is why KFF’s analysis frames deductibles and premiums together rather than separately. The 58% premium increase and the 37% deductible increase are two facets of the same underlying shift: a Marketplace where the coverage people can actually afford has become thinner relative to what they had before.
What does the enrollment picture look like as of July 2026?
The July 15, 2026 KFF Quick Insights update incorporated the latest CMS monthly effectuated enrollment data, showing February 2026 enrollment at 19.2 million, down from 21.8 million in February 2025, a 12% decline. KFF’s state-by-state analysis, published July 2026, found that every state except New Mexico saw enrollment decline, with Ohio, Oklahoma, and Arizona each losing roughly 30% of their enrolled population. New Mexico was the only state to gain enrollees because it fully replaced the expired federal enhanced subsidies with state-funded subsidies, making it a natural test case for what state-level subsidy replacement can accomplish.
The 19.2 million February effectuated figure is still likely to fall further as mid-year non-payment cancellations accumulate. KFF’s full-year projection of 17.5 million reflects that expected attrition.
What does this mean for 2027?
The deductible and enrollment data are directly connected to the 2027 premium trajectory. When healthier, cost-conscious enrollees leave the Marketplace or shift to Bronze plans, the remaining risk pool is weighted toward people with higher healthcare needs. Insurers price their 2027 premiums partly based on the 2026 risk pool experience, which is one of the mechanisms driving the proposed median 15% premium increase for 2027 now being reviewed by state regulators, according to KFF’s updated 2027 premium analysis covering 276 insurers across all 50 states.
That proposed 15% increase, if finalized, would mean the average Marketplace deductible benchmark is likely to rise again in 2027 if the pattern of enrollees shifting toward Bronze and away from Silver continues.
What are the alternatives for someone who cannot absorb these cost increases?
The deductible data makes one alternative combination particularly worth noting. A health sharing ministry paired with a Direct Primary Care membership typically runs $175 to $600 a month total for an individual and provides unlimited primary care access without a deductible for routine care, alongside community sharing for major medical events under written Member Guidelines. For a healthy individual above the subsidy cliff who is facing a Bronze plan with a $7,186 deductible they are unlikely to meet in a normal year, the comparison is worth running seriously.
DPC memberships specifically address the gap that high deductibles create for routine care: when a Bronze plan’s deductible means you effectively pay full price for primary care visits until you’ve spent $7,000, a DPC membership at $75 to $120 a month that covers unlimited primary care visits changes the practical math considerably. Starting January 2026, DPC membership fees are also HSA-reimbursable up to $150 a month for an individual, improving the tax efficiency of this combination further.
For people who remain in the ACA Marketplace and want to maximize the value of a Silver plan, checking CSR eligibility at incomes below 250% FPL is the single highest-value step available. CSR-enhanced Silver plans, which are only available to people within that income range through HealthCare.gov, can bring deductibles to levels far below even the pre-enhanced-subsidy average. The KFF data showing record-low Silver plan selection suggests many CSR-eligible enrollees may be leaving money on the table by defaulting to Bronze.
Frequently Asked Questions
Why did the average ACA deductible increase so much in 2026? The 37% deductible increase is primarily a reflection of plan tier shifts rather than plans themselves becoming less generous. When enhanced premium tax credits expired at the end of 2025, many lower-income enrollees who had been on Cost-Sharing Reduction-enhanced Silver plans with low deductibles shifted to cheaper Bronze plans with much higher deductibles. KFF describes this as “the steepest increase in deductibles ever seen in this market,” driven largely by that structural shift in who is choosing which plan tier.
What is the average ACA Marketplace deductible in 2026? According to KFF’s May 2026 analysis, the average Marketplace deductible across all plan tiers is $3,786. For Silver plans specifically, the average deductible is $5,304. For Bronze plans it is $7,186. These figures come from KFF’s analysis of CMS and state-based Marketplace open enrollment data.
If I’m still on a Silver plan, is my deductible $5,304? Not necessarily. The $5,304 figure is the average for all Silver plans without Cost-Sharing Reductions. If your income is below 250% of the federal poverty level (approximately $39,125 for a single individual in 2026) and you are enrolled in a Silver plan through HealthCare.gov, you may qualify for CSR-enhanced Silver plan benefits that significantly lower your deductible, sometimes to $500 to $1,500. If you haven’t confirmed your CSR status, checking directly at HealthCare.gov is worthwhile.
Why did so many people switch from Silver to Bronze plans in 2026? Silver plan premiums are typically higher than Bronze plan premiums. When enhanced tax credits expired, many enrollees faced sharp increases in their Silver plan costs and switched to Bronze plans to keep monthly premiums affordable. While Bronze plans cost less per month, they expose enrollees to much higher costs before insurance begins to cover care, making total cost of use in a year with significant medical needs potentially much higher than the premium comparison alone would suggest.
Does the deductible increase affect whether a health share or DPC combination makes sense for me? It strengthens the comparison for healthy individuals above the subsidy cliff. If you are facing a Bronze plan deductible of $7,186 and are generally healthy enough that you are unlikely to meet it in a given year, you are effectively self-funding most of your routine care anyway. A DPC membership at $75 to $120 a month can cover that routine care more efficiently, and a health share provides major medical protection at a lower monthly cost than an unsubsidized Bronze plan for many individuals. The comparison is worth running with your specific income, health history, and risk tolerance in mind.
This article is for general informational purposes only and is not insurance, legal, or financial advice. Deductible, enrollment, and premium figures referenced here come from KFF’s May 19, 2026 analysis of ACA Marketplace enrollment and deductibles, the July 15, 2026 KFF Quick Insights update, the Peterson-KFF Health System Tracker, and Wakely Consulting Group estimates, all publicly available as of August 2026. Individual plan costs and CSR eligibility depend on your specific income, household size, and plan selection. Always confirm your subsidy and CSR eligibility at HealthCare.gov before making a coverage decision.
By the Modern Healthcare Works team