Marketplace Open Enrollment Tops 22.8 Million Selections for 2026 Coverage
Key Summary
- 22.8 million consumers selected individual market health insurance plans during the 2026 Marketplace Open Enrollment Period, according to the Centers for Medicare & Medicaid Services (CMS).
- States using HealthCare.gov accounted for 15.6 million enrollments, while state-based Exchanges (SBEs) reported 7.2 million selections nationwide.
- 2.8 million enrollees were new consumers, with the majority—20.0 million—returning or automatically re-enrolled from 2025 coverage.
CMS reports that Marketplace enrollment remains strong for the 2026 plan year, with nearly 22.8 million consumers selecting coverage nationwide. The data, released during the 2026 Open Enrollment Period (OEP) that began November 1, 2025, reflect cumulative plan selections across federal and state-based Exchanges in the US.
CMS data show 22 774 847 cumulative plan selections for 2026 Marketplace coverage across all Exchanges. Of these, 15 558 636 enrollments occurred in the 30 states using the HealthCare.gov platform, while 7 216 211 plan selections were reported by 20 state-based Exchanges and the District of Columbia operating their own platforms.
New consumers accounted for 2 803 016 plan selections nationwide, including 2.1 million through HealthCare.gov and 701 900 through SBEs. The majority of enrollees—19 971 831 consumers—were classified as returning, meaning they either actively selected a plan or were automatically re-enrolled from 2025 coverage.
State-level data show significant geographic variation. Florida (4.47 million) and Texas (4.11 million) led all states in HealthCare.gov enrollments, together representing more than half of federal platform plan selections. Among SBEs, California reported 1.94 million enrollments, followed by Georgia (1.32 million) and New Jersey (486 231).
CMS emphasized that the reported figures represent cumulative plan selections, net of cancellations, and do not reflect effectuated enrollment. Consumers generally must pay their first month’s premium for coverage to take effect.
Clinical Implications
For health care executives and health system leaders, sustained Marketplace enrollment has direct implications for payer mix, access to care, and financial planning. High enrollment volumes suggest continued reliance on Marketplace coverage as a key access point for individual insurance, particularly in large states such as Florida, Texas, and California.
The large proportion of returning consumers indicates relative continuity in coverage, which may support improved care management and utilization forecasting. However, the presence of nearly 2.8 million new consumers highlights ongoing demand for outreach, navigation, and provider network adequacy.
Because CMS does not report effectuated enrollment in this release, providers and payers must remain cautious in translating selections into expected utilization. Monitoring premium payment completion and retention will remain critical for revenue cycle planning and population health strategies in 2026.
Conclusion
CMS data indicate robust participation in the 2026 health insurance marketplaces across the US. For health business leaders, the scale and distribution of enrollment reinforce the Marketplace’s central role in coverage access, while highlighting the importance of monitoring effectuated enrollment and state-level trends moving forward.
Reference
Centers for Medicare & Medicaid Services. Marketplace 2026 Open Enrollment Period Report: national snapshot. CMS.gov. January 12, 2026. Accessed January 16, 2026. https://www.hmpgloballearningnetwork.com/site/ihe/news/cms-launches-balance-model-expand-glp-1-coverage-us
