Arizona ACA health insurance enrollment plummets as premiums soar without enhanced subsidies

About 70,000 fewer Arizonans have signed up for health insurance through the Affordable Care Act after Republicans in Congress refused to extend tax credits and premiums soared.

One analysis found that insurance premiums on the ACA marketplace for Arizona jumped nearly 30% on average. Data released this week by the Centers for Medicare & Medicaid Services show that 353,000 Arizonans have signed up for 2026 ACA insurance plans, nearly 17% fewer than purchased plans for 2025.

The open enrollment period for the ACA ends on Thursday.

At a virtual press conference on Wednesday organized by Protect Our Care Arizona, U.S. Sen. Ruben Gallego said that Republicans created the crisis that will force Arizona families to choose between health care and other essential costs, like housing and food.

"This is the situation they were put in by Republicans," the freshman Democratic senator said. "This is the situation we were put in by Republicans like Juan Ciscomani in Arizona, even Eli Crane, whose districts have combined hundreds of thousands of Arizonans that are now going to have to make a very, very tough decision."

Instead of extending enhanced insurance premium subsidies that were implemented under President Joe Biden, Gallego said his Republican colleagues plan to "use the savings they're going to get for these subsidies and just give more and more tax cuts."

"That doesn't help the families that are hurting right now. It doesn't help the people that are trying to figure out how to get safe, reliable health insurance and stay out of the poor house because they end up going into debt," he said.

Republicans have defended letting the subsidies lapse by arguing that the subsidies are an expensive, temporary fix that fails to address the underlying high costs of health care for all Americans. The leading proposal GOP lawmakers have put forward focuses on enhancing health savings accounts in lieu of reducing the cost of health insurance.

Senate Republicans reject extending ACA tax credits, instead propose spending on health-savings accounts

Other speakers at the press conference shared how the skyrocketing premiums have put them in no-win situations. Small business owner Robert Hess III said that affordable health insurance he got through the ACA allowed him to have surgery for a slipped disc in his back that otherwise would have cost him $100,000.

But his coverage will be worse this year, because that's all he can afford since the premiums jumped in price so much.

"This year, when I logged in to select my health plan, I noticed that those premiums have gone up. I think everyone that has logged in to see it noticed hundreds of dollars more every month," Hess said. "So I made the tough decision to reduce my plan from a silver plan to a bronze plan because that's what I could fit in my budget."

Likewise, Steve Gomez and his family will have worse insurance in 2026 — and that insurance won't cover the doctors who treat his school-age son who had a heart transplant when he was just 6 weeks old.

"Our premium was $3,431 a month — $700 more than my mortgage. We got it down to $2,200," he explained. "Great savings, right? Yeah, except for the fact that the coverage is garbage. None of Anthony's doctors at Phoenix Children's Hospital are in network, and because of the way ACA plans are structured, they don't offer out-of-network benefits."

And an upcoming necessary annual procedure for Anthony won't be covered now, Gomez said.

"If we do not get a continuation of care or exceptions, we are looking at well over $80,000 for that day out of pocket," he said. "That's not to mention the build cost for his quarterly visits is well over $5,000. The $80,000 is assuming things go well. If not, we're looking at $100,000."

Republicans control the presidency and both chambers of Congress, but not only have they not done anything to lower health care costs, they've actively made things much more expensive, Gomez said.

"This is Trump's second term, and from the beginning, he touted ripping up the ACA because they had such a better plan they were going to replace it with," he said. "Now, we go to his second term where he's got 'concepts of a plan.' He ain't got a damn thing. Their plan is to squeeze Americans day by day for health care costs and throw them to the side and make them choose: Do I pay for my utilities? Do I pay for food? Or do I pay for health care?"

Arizona Mirror is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Arizona Mirror maintains editorial independence. Contact Editor Jim Small for questions: [email protected].