Access Health predicts 8% enrollment drop if enhanced tax credits lapse

HARTFORD -- Tens of thousands of Connecticut consumers are signing up for health insurance in 2026 through Access Health CT amid uncertainty over the future of Affordable Care Act subsidies that helped nine out of 10 enrollees in the state-run marketplace pay for coverage last year.

The latest open enrollment period began Nov. 1 and concludes Jan. 15, 2026. Enhanced ACA tax credits that provided a reported $350 million to $400 million in premium subsidies to more than 140,000 state residents last year are due to expire Dec. 31, unless Congress and President Donald Trump extend them.

Access Health CT reported 159,646 state residents enrolled in 2025 and 143,320 received ACA credits, representing nearly 90% of all enrollees. A record 151,151 people signed up during the last open enrollment period, including 122,128 customers who renewed their 2024 policies for 2025. People can enroll outside of open enrollment periods under certain circumstances, including losing health coverage through a job, getting married, or moving to Connecticut from another state or country.

Sign-ups are only down slightly compared to last year's open enrollment period, said James Michel, CEO of Access Health CT.

"We're doing better than expected," he said Nov. 25.

Through Nov. 24, slightly more than 120,100 state residents had enrolled in a health plan since Nov. 1, including approximately 113,300 renewals, Michel said.

Rather than dropping health coverage, he said renewing enrollees are switching to health plans that charge lower monthly premiums and higher out-of-pocket costs. But Access Health CT is still anticipating declines in overall enrollments and renewals under the present uncertain circumstances.

After setting enrollment records in 2024 and 2025, Access Health CT is now projecting an 8.2% decrease in medical plan enrollment due to increasing premiums. Automatic renewals also are expected to decline from a historical average of 86% to 73%, largely due to the loss of the enhanced subsides for approximately 28,000 people earning more than 400% of the federal poverty level.

But Michel said these projections are subject to change if the expiring ACA subsidies are extended in full or in part.

Meanwhile, he encouraged state residents concerned about the cost of health plans to visit the Access Health CT website and click "Get Help" to search its database of certified brokers to find plans they can afford free of charge. Enrollment specialists also are available to assist people.

"All hope is not lost in that there are still subsidies available, just not at the same level," Michel said.

The enhanced ACA tax credits initially were enacted in 2021 to bring down the cost of purchasing health coverage on state insurance exchanges during the COVID-19 pandemic, and later were extended through 2025.

Michel said the enhanced subsidies were drivers behind the record enrollments of 2024 and 2025. He said the biggest growth was among customers earning more than 400% of the federal poverty level who had not been previously eligible.

State residents have been advised to wait as long as they can to obtain a health plan through Access Health CT to see if Congress and the White House agree to some extension of the expiring ACA subsidies. But the clock is running down for those looking to be covered on Jan. 1.

Customers have to sign up for a health plan through Access Health CT no later than Dec. 15 to have coverage start Jan. 1. Otherwise, if they enroll between Dec. 16 and Jan. 15, coverage will begin Feb. 1.

The ACA subsidies figured prominently in the government shutdown fight that ended earlier this month. Democrats in Congress demanded Republicans and Trump agree to extend the tax credits in exchange for Democratic votes for reopening the government. But a group of moderate Senate Democrats agreed to help end the record 43-day shutdown for a Republican promise that the Senate would vote on extending the enhanced tax credits in mid December.

The White House has circulated a proposal to extend the ACA subsidies for two more years while imposing new income limits and requiring every enrollee to pay at least a nominal monthly premium.

Meanwhile, there is a possibility of the state government partially supplementing the federal tax credits if they expire. In a recent special session, the legislature authorized Gov. Ned Lamont to spend up to $500 million out of the budget reserve fund to offset federal budget cutbacks, including for health care. This spending authority lapses on Feb. 4 when the regular 2026 legislative session opens.

Michel said staffers at Access Health CT have developed a range of contingency plans if the tax credits get extended in one form or another. He said plans also have been made should Connecticut resort to state subsidies if the federal tax credits disappear.

The governor's office is closely watching what is happening in the nation's capital, said Rob Blanchard, Lamont's director of communications. As outlined, the president's proposal is an encouraging development, he said.

"We're certainly encouraging Congress to get together and extend them," Blanchard said. "The current plan that was presented is a step in the right direction, but if those subsidies aren't extended, we'll have to have a conversation about what we can do to make sure health insurance rates aren't jacked up to an unsustainable level."

But Lamont has said the state will be unable to pick up a $350 million to $400 million cost to replace the expiring ACA subsidies.