Cut to ACA enrollment period could cost 1M Americans coverage

The Trump administration is proposing to shorten the annual enrollment period for Affordable Care Act health insurance by one month, a move that one group warned could put more than 1 million Americans at risk of losing coverage.

According to a proposed rule released earlier this month, open enrollment for 2026 would run from Nov. 1 through Dec. 15, instead of through Jan. 15.

In a fact sheet, the Centers for Medicare and Medicaid Services said, “This proposal aims to reduce consumer confusion, streamline the enrollment process, align more closely with open enrollment dates for many employer-based health plans, encourage continuous coverage, and reduce the risk of adverse selection from consumers who otherwise may wait to enroll until they need health care services.”

This isn’t the first time the Trump administration attempted to slash the amount of time Americans have to choose a health plan. In 2017, Trump reduced ACA open enrollment to 45 days.

Last year, a record 24 million people chose plans during the most recent ACA open enrollment period, mainly due to expanded tax credits that made plans available to people for little or no monthly premiums.

Final month ACA enrollment in 2024

But in a report released this week, ValuePenguin looked at the number of people who enrolled in coverage during the last month of the open enrollment period for 2024. Based on its enrollment figures, ValuePenguin found that 1.01 million people signed up for a plan during the last month of open enrollment. That figure represented about 4.7% of the total enrollment for 2025. If the new rule went into effect in 2024, these late enrollees wouldn’t qualify for coverage.

People in Colorado, New Mexico and West Virginia were the most likely to use the last month of open enrollment for 2024 plans. In those states, more than 9% of people who obtained an ACA plan did it between Dec. 17 and Jan. 16.

In Texas, nearly 200,000 people got coverage between Dec. 17, 2023, and Jan. 16, 2024. In Florida, 177,356 people signed up in the last month of open enrollment.

Consumers usually must sign up for medical insurance by Dec. 15 to have coverage that begins in the new year. So if their current policy ends on Dec. 31, they must sign up for a plan by Dec. 15 to avoid a gap in coverage. Those who sign up prior to Jan. 15 can have their coverage begin on Feb. 1.

Those who go through certain life events, like moving or having a baby, can sign up for marketplace coverage at any time of the year. Consumers may be eligible for a special enrollment period if they've moved, lost other insurance, recently been married or divorced, had a child, lost their job, or if their income has dramatically changed.

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