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About 15% fewer Oregonians signed up for Affordable Care Act insurance plans in 2026 than in 2025, one of the largest drops in the nation, according to a WW review of federal data released this week.
The Affordable Care Act marketplace offers regulated—and often subsidized—private health insurance to people who don’t receive it in more common ways, such as through their employer, the Oregon Health Plan, or Medicare.
The enrollment dip comes as health insurance premiums have surged across the board and state lawmakers head to Salem looking to contain costs. It also comes after Congress let enhanced subsidies for the ACA health insurance plans expire, meaning many middle-class Americans in particular saw big rate hikes this year.
Sticker shock was widely expected to make many people less likely to purchase health insurance on the marketplace. And with the Jan. 15 close of the 2026 open enrollment period, new preliminary federal data suggests that, indeed, fewer people thought buying a ACA plan this year was worth it.
Just under 23 million Americans enrolled on ACA plans during the latest open enrollment period, a 5% dip from the 24.2 million who signed up during the same period last year.
It’s the first drop in marketplace enrollment in years, although nationwide enrollment remains well above historic levels, following a surge since 2020, when just 11.4 million people were signed up for ACA plans, according to the health research group KFF.
Oregon, which has a achieved a relatively high rate of overall health insurance coverage, has followed a different pattern. It’s ACA enrollment hovered around 140,000 for years, before dipping this year to 118,000.
The 15% drop is the seventh largest in the nation, according to the WW review, behind North Carolina, Ohio, West Virginia, Indiana, Delaware and Arizona. (Washington state saw an 8% dip.)
Since Oregon’s marketplace operates on the Healthcare.gov website, the OHA does not have detailed data to explain why people didn’t renew Marketplace plans, and to what extent those people can receive coverage elsewhere, Oregon Health Authority spokeswoman Franny White says in an email. When the state switches to its own state-based marketplace later this year, it will have more detailed data to analyze.
Still, the agency has some theories. “While OHA doesn’t know exactly why approximately 15% fewer people purchased 2026 plans through the Oregon Health Insurance Marketplace, community members reported that the loss of enhanced premium tax credits made coverage unaffordable for some,” White says.
In an earlier announcement, the agency offered other details on the open enrollment period. A smaller share of Oregonians who sought financial assistance received it than in the past, it said. And it said individuals with incomes between 200% and 400% of the federal poverty level saw premium increases of $90-$165 per month.
Meanwhile, the agency noted, it heard from insurers that some people who did select plans chose inferior ones, with higher out-of-pocket costs.
