ACA Enrollment Shrinks as Seniors Face Rising Costs Before 2027 Vote

WHO:

CNN - Holly Hendricks, 49, of Sarasota, Florida, has an autoimmune disease, lupus and rheumatoid arthritis; she works full time as a caretaker for a veteran.

CNN - Kara Windeler, of Clearwater, Florida, has rheumatoid arthritis, long COVID and severe allergies; she had worked as a skincare specialist.

CNN - Julie Kay Roberts, a consultant from Southlake, Texas, dropped her coverage and is seeking a lower-premium plan.

CNN - Cynthia Cox, director of KFF’s Program on the ACA, discussed enrollment and premium trends; KFF is a nonpartisan health policy research group.

ABC News - Barbara Weigand, 83, of North Canton, Ohio, is enrolled in Medicare Advantage and recently faced shoulder surgery and a bladder cancer diagnosis.

ABC News - Juliette Cubanski directs KFF’s program on Medicare policy; Nancy LeaMond is AARP’s executive vice president and chief advocacy officer.

NPR - Joshua Brooker oversees a Pennsylvania insurance agency; Jason Fine runs a Florida brokerage; Stacey Pogue is a senior research fellow at Georgetown University’s Center on Health Insurance Reforms.

NPR - The National Association of Benefits and Insurance Professionals sued over the broker moratorium; Health Agents for America also filed suit.

WHAT:

CNN - ACA marketplace enrollment was 19.2 million in February, 2.6 million below the same period the prior year. KFF estimated individual-market coverage was down more than 4.6 million by June year over year.

CNN - Benchmark silver-plan premiums are projected to rise an average 13% in 2027, the second consecutive year of double-digit increases and the fourth-largest increase since ACA exchanges began. The previous year’s average monthly-payment increase was 58%.

CNN - Eighteen state-run exchanges reported accelerating enrollment declines; disenrollments were nearly 34% higher by May than in the comparable period a year earlier.

CNN - Republican-held districts had 67% of enrollment declines while accounting for 55% of enrollees, according to KFF.

CNN - Mississippi enrollment fell from 338,000 at the end of 2025 to fewer than 192,000 in February and about 125,000 in September; it rose to 135,000 in late October. Massachusetts had about 8,000 fewer exchange enrollees in September than in February. New Mexico’s enrollment increase had largely disappeared by fall.

CNN - A White House fraud task force announced it was removing 760,000 ACA enrollees. Insurers’ departures mean about 1,200 counties will have only one or two exchange insurers, compared with about 800.

CNN - Hendricks’s monthly premium rose to nearly $1,100, more than triple its prior level; she became uninsured and later spent a month hospitalized with sepsis, anticipating bills above $500,000. Windeler’s premium rose from about $225 to $450; she expects to lose coverage and plans to ration medication. Roberts’s premium rose from about $490 to $1,240; she hopes to find coverage costing no more than $600 monthly.

ABC News - An AARP poll found 83% of voters over 50 were extremely motivated to vote in the midterms. A KFF survey found about four in 10 adults had not taken medication as prescribed because of cost; about one in five had cut pills or skipped doses.

ABC News - Family caregivers spend an average $11,508 annually, nearly 60% more than the $7,242 reported in 2021. About one-third of Americans over 50 provide regular care to an adult relative or friend.

ABC News - Social Security’s cost-of-living adjustment will rise 3.6% in 2027, adding $75 monthly for nearly 72 million Social Security recipients and about 7.3 million Supplemental Security Income beneficiaries. Trustees projected full benefits could become unavailable beginning in 2034, with revenue then covering about 83%.

ABC News - ACA marketplace enrollment fell by 1.2 million after enhanced subsidies expired. The administration said removing 760,000 enrollees would save $2.2 billion; new immigrant eligibility limits could eventually leave another 1 million people uninsured.

NPR - ACA out-of-pocket maximums will rise 13% in 2027, to $12,000 for individuals and $24,000 for families. The current limits are $10,600 and $21,200.

NPR - The National Association of Benefits and Insurance Professionals sued on Oct. 15, saying the moratorium affects 19,000 agents; Health Agents for America sought a temporary restraining order on Oct. 21.

WHERE:

CNN - The reported enrollment declines include state exchanges in Mississippi, Massachusetts and New Mexico; Idaho reported flat or lower subsidized silver premiums in many parts of the state.

ABC News - Weigand lives in North Canton, Ohio.

NPR - The federal marketplace serves 29 states; its new agent-authorization rules do not apply to state-based exchanges.

WHEN:

CNN - ACA open enrollment began Sunday in most states; the article says Idaho’s exchange opened Oct. 15. The article describes Windeler becoming uninsured on November 1.

ABC News - Medicare open enrollment began in mid-October; ACA enrollment runs through Jan. 15.

NPR - ACA open enrollment began Nov. 1 in most states; Idaho, Connecticut and Massachusetts opened earlier. Agents not registered in 2026 cannot assist with federal-marketplace enrollment for 2027 until February at the earliest.

WHY:

CNN - Enrollment declines followed expiration of enhanced premium subsidies; rising premiums and household costs also made coverage harder to afford.

ABC News - Older adults cited Medicare costs, prescription prices and long-term care expenses as pressures on household budgets.

NPR - CMS said identity checks and the broker moratorium target fraud and improper enrollments; the agency cited significant compliance concerns involving newly registered agents.

HOW:

NPR - Federal-marketplace consumers using agents must authorize a specific agent with a one-time code or link. Consumers CMS considers high-risk must verify their identity, potentially through Experian or by submitting identification through HealthCare.gov.

NPR - The One Big Beautiful Bill Act limits subsidies for many lawfully present immigrants, including H-1B visa holders, refugees, asylees and people with temporary protected status. Green-card holders, certain Cuban and Haitian immigrants, and citizens of Micronesia, the Marshall Islands or Palau remain eligible.

(UPDATED November 1, 2026 19:01 UTC)

ACA enrollment is falling as enhanced subsidies expire and rising premiums make coverage harder to afford. Benchmark premiums are projected to jump 13% in 2027. Brokers are suing over new federal restrictions, which officials say target fraud.