Final 2026 Open Enrollment Report: Metal Levels (Part 5A)

Note: This section is so chock full of tables & graphs that I've broken it into two sub-sections...I'll be posting the 2nd half of Part 5 over the weekend...

If you've ever wondered why healthcare wonks (myself included) rarely talk about the ACA's Catastrophic Level plans (or at least it was rare up until last year, when the Trump Regime decided to try opening up the floodgates on them), and why the only time I usually discuss Platinum Plans is in the context of high-CSR enrollees being eligible for "Secret Platinum" plans (labeled as Silver), the first table below should explain why.

Catastrophic ACA plans are only available at all in 34 states +DC (this is actually down from 40 states +DC last year), and less than 0.3% of all ACA exchange enrollees choose Catastrophic plans...just 67,000 nationally. Even if you only include the states where they're available this only increases to 0.36% (although they did reach 4.4% of total enrollments in Montana this year).

At the opposite end, Platinum plans are only available in 18 states (+DC)...and again, just 0.4% of all exchange enrollees choose Platinum (even in the states where they're available they only make up 0.9%). This ranges from virtually none in Tennessee, Maine & Utah to 57,000 in California...just 96,000 nationally.

Combined, Catastrophic and Platinum plans make up a mere 0.7% of all exchange enrollments nationally...basically a rounding error; this is why just about every metal level ACA data discussion focuses on Bronze, Silver and Gold plans only.

Nearly 40% of enrollees selected Bronze plans this year, which is up a whopping ten points over 2025 for some pretty obvious reasons which I'll discuss further soon.

By contrast, only 42.6% of enrollees selected Silver...down 13.6 percentage points from last year's 56.2%.

Finally, Gold plan enrollment, which I was expecting would also drop, actually increased in both raw numbers as well as as a percentage of the total, from 13.2% to 17.2% of all 2026 OEP plan selections...again for reasons I'll discuss soon.

The states with the highest Gold plan uptake this year was once again New Mexico (over 60%, although this is still down from 68.6% last year), followed by Washington and Vermont which hover just over and under the 50% mark. The lowest Gold uptake is again Mississippi at just 0.6% of total enrollment.

However, it's important to note that over 57% of Mississippi enrollees have "Secret Platinum" plans (ie, CSR Silver plans w/actuarial values of 87% or higher), which means 58% of them effectively have Gold or Better (Gold+) plans.

Nebraska has the highest percent of enrollees in Bronze plans (nearly 2/3), while New Mexico understandably has the lowest at 3.1%.

Overall, Catastrophic & Bronze plans are up a combined 26%, which again isn't surprising, nor is the fact that Silver enrollment has plummeted by 28% & the nominal Platinum enrollment has dropped by 19%. The only surprise here is that Gold actually went up by an impressive 24% year over year...but when you look at this at the state level it starts to become more clear.

Here's what this looks like visually:

WARNING: The table below is a monster which includes the year over year changes (both raw numbers and percentages) for all five metal levels by state. It's almost certainly not going to be readable on anything but the highest-resolution monitors, so I've broken it into five smaller tables beneath the main one:

Catastrophic Plans: Considering how much effort the Trump Regime put into shoving Catastrophic plans down everyone's throats (Trump's Council of Economic Advisors was actually projecting up to 3 MILLION people to enroll in one), the actual 2026 OEP Catastrophic Plan selection tally is pretty laughable: While it did increase by an impressive 24% over 2025, that still only brings the grand total to...fewer than 68,000. The Trump Regime was off by a factor of 44x or so.

It probably didn't help that carriers in 6 additional states decided to bail on Catastrophic plans entirely this year (a colleague of mine speculated that, ironically, some of them likely did so in response to Trump opening the floodgates on Catastrophic eligibility, since that would play havoc with their risk pools if a significant number of enrollees actually took them up on the offer).

There was one state which went the other way, however: Arkansas, which didn't offer Catastrophic plans last year, did have some available this time around...but only 1,200 Arkansans took them up on it.

Bronze Plans: While Bronze enrollment shot up 26% nationally, there was a wide range at the state level from a 19% drop in Bronze enrollment in West Virginia to a whopping 84% increase in Texas, where it jumped from ~700,000 people to nearly 1.3 million.

Bronze enrollment also rose dramatically in Mississippi (+77%), New Jersey (+60%) and Alabama (+58%). There's only 5 states where it dropped year over year: West Virginia, Washington State, Indiana, New York and Oregon.

Silver Plans: This is the mirror image of Bronze Plans: Silver enrollment only increased in 6 states (New York, Massachusetts, DC, Connecticut, Maryland and New Mexico), and New Mexico is the only one where it increased significantly (53%...the next highest is Maryland at 10%).

Silver enrollment dropped in every other state, including by 50% or more in North Carolina, Arkansas, Vermont and Washington State.

Overall it dropped by 28% nationally.

Gold Plans: This is the most interesting of the group. As I noted above, given the expiration of the enhanced federal tax credits along with new Trump Regime regulations causing several hundred thousand legally-residing immigrants to no longer be eligible for any tax credits at all, seeing several million people downgrade from higher-value plans (Platinum, Gold, Silver) to lower-value ones (Bronze/Catastrophic) is not only unsurprising but is something I was warning would likely happen months ago.

While this is exactly what happened with Silver & Platinum (see below), however, it didn't happen with Gold plans, which actually saw enrollment increase by nearly 770,000 people!

In the second part of my Metal Level entry I'll dig into what happened here, which you can probably figure out by looking at the state-level breakout:

• Gold enrollment dropped, as expected, in 38 states, and only increased nominally (by less than 5%) in 3 more.

• In the remaining 10 states, however, Gold enrollment increased by anywhere from 5.8% in DC to a jaw-dropping 545% in Arkansas...and if you think "Premium Alignment" is the phrase that pays, you're correct. Again, this entry is getting too long to delve into that so I'll save it for the 2nd half.

Platinum Plans: I don't have a whole lot to say about Platinum plans given that, as noted above, they're only available in 19 states this year (one fewer than last year...they seem to have disappeared in Indiana and West Virginia while becoming newly-available in Arkansas).

Platinum enrollment has never been very high, and it dropped below the 6-figure threshold in 2026 with only ~96,000 people selecting a Platinum plan, down 19% from 118,000 last year.

Pennsylvania and Tennessee actually did see Platinum enrollment double and triple respectively, which sounds impressive until you realize that it "doubled" from 508 to 1,052 people and "tripled" from 33 to 97 people in each state. In raw numbers, only New York (11,179) and California (57,720) broke five figures this year.

Again, I'll pick up on all of this in the second half of my Metal Level analysis; stay tuned...