In response to preliminary data showing that ACA enrollment declined drastically in 2026, the Trump administration and state governments are reportedly fighting over whether better policing of fraud or the loss of enhanced ACA subsidies is to blame. Although we do not yet know the final enrollment total for 2026, as enrollees will continue to drop off throughout the year, the plans selected so far tell a clear story of a cost problem. The average selected plan’s premium increased by 58 percent and its deductible increased by 37 percent. Average premiums might have increased even more if not for the 33 percent increase in Bronze plan selections, meaning enrollees are trading lower premiums for higher cost-sharing. These price increases have driven an estimated one in ten 2025 ACA enrollees to become uninsured, and a majority of those who returned to the exchanges face higher prices. As a result of this destabilization of the exchanges, insurance carriers are pulling out, providers will face greater uncompensated care burdens, and consumers are growing more certain that our healthcare system is unaffordable and broken.