Every year, even when the ACA is running smoothly, there are always changes in market participation, as different insurance carriers enter or exit the individual market in certain states or either expand or shrink what parts of the state they offer healthcare policies in.
2026 is no exception, and given the massive turmoil the ACA exchanges are undergoing right now (due primarily to the expiring federal tax credits as well as regulatory changes made by the Trump Regime's so-called "Integrity & Affordability Rule"), there's either 13 or 32 insurance carriers throwing in the towel in one or more states, depending on how you count a carrier operating in multiple states or under multiple subsidiary brandings.
It's important to keep in mind that the following list probably isn't comprehensive--it includes the carriers which I've confirmed are pulling out statewide (with one exception: Meridian Health Plan of Michigan is only pulling out of parts of the state). There's likely one or two that I've missed, especially given that several of these have only made their final decisions within the past week or so.
With the 2026 ACA Open Enrollment Period officially starting on November 1st, and with millions of ACA enrollees being bombarded with scary letters from their insurance carriers and headlines warning of massive premium hikes, residents of six states* (as of this writing) can already enter their own household information to find out how much their net health insurance premiums are going to increase starting January 1st, 2026:
Twelve years ago, the Wall St. Journal ran a story about the impact of the American Taxpayer Relief Act of 2012, a sweeping tax bill signed into law by President Obama which locked in the Bush tax cuts for lower & middle-class households while allowing them to expire on schedule for wealthier Americans:
A compromise measure, the Act gives permanence to the lower rate of much of the Bush tax cuts, while retaining the higher tax rate at upper income levels that became effective on January 1 due to the expiration of the Bush tax cuts. It also establishes caps on tax deductions and credits for those at upper income levels. It does not tackle federal spending levels to a great extent, rather leaving that for further negotiations and legislation. The American Taxpayer Relief Act passed by a wide majority in the Senate, with both Democrats and Republicans supporting it, while most of the House Republicans opposed it.
Nevada has around ~110,000 residents enrolled in ACA exchange plans, 87% of whom are currently subsidized. I estimate they also have another ~23,000 unsubsidized off-exchange enrollees.
JULY 31st, 2025 - Nevadans Get a Preview of 2026 Proposed Health Insurance Rate Changes for Upcoming Open Enrollment
[CARSON CITY, NV] - Starting August 1st, Nevada consumers who shop for their health insurance on the individual health insurance market can view and provide comments on proposed rate changes for Plan Year 2026.
The Nevada Division of Insurance (Division) has received and made public on its website the 2026 proposed rate changes from health insurers intending to sell plans on and off the Silver State Health Insurance Exchange (the "Exchange"). The Exchange is the state agency that assists eligible Nevada residents to purchase affordable health and dental plans.
With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.
USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.
Over 110,000 Nevadans got enrolled, marking the largest enrollment in the history of Nevada’s marketplace
CARSON CITY, Nev. – Nevada Health Link has achieved a historic milestone this year with its record-setting Open Enrollment Period for Plan Year 2025. With over 110,000 Nevadans enrolling in affordable and comprehensive health and dental coverage through the state-based marketplace, this achievement underscores the critical importance of providing accessible and affordable health insurance options to Nevadans across the state.
“Reaching the highest enrollment numbers in Nevada Health Link’s history is a milestone we’re incredibly proud of,” said Russell Cook, Executive Director of Nevada Health Link. “Health insurance is more than just a safety net in case of a medical emergency – it's peace of mind, financial security, and, ultimately, a pathway to better health outcomes for individuals and families across our state. This record-setting enrollment underscores the importance of our mission to prioritize the well-being of Nevada’s communities.”
With Open Enrollment going on now through Nevada’s official health insurance marketplace known as NevadaHealthLink.com, there are less than two weeks left for Nevadans to get coverage starting the first of the new year. Nevadans must enroll in a plan by 11:59 p.m. on December 31, 2024, for their health insurance coverage to be effective starting January 1, 2025.
Those who don’t enroll by December 31 will still have a chance to enroll in coverage through January 15, 2025, however, those who enroll between January 1 and January 15, 2025, will have coverage beginning February 1, 2025.
Open Enrollment began on November 1 and since then, over 30,000 Nevadans have actively enrolled in a plan, with 15,236 being new to enroll on Nevada Health Link. The Open Enrollment Period is the only time of year Nevadans can freely enroll in a health insurance plan through NevadaHealthLink.com without experiencing a qualifying life event, such as getting married, having a baby or moving.
Nevada Health Link hasn't published a formal press release about this yet (I'm assuming they're waiting until they actually break 100K to do so, which would be perfect timing since the deadline to enroll for January 1st coverage is New Year's Eve), but I just found this in their December Executive Director's Report from 2 days ago:
OPEN ENROLLMENT 2025
Following the close of week seven, the Plan Year 2025 OEP is the Exchange’s highest performing to date. The annual passive renewals (or Auto-renewals) job was completed in mid-October with a greater than 99.9% renewal success rate.
Holy crap. That's astonishing.
When OEP began on November 1, 91,555 individuals were enrolled in 2025 health coverage, and 16,820 individuals were enrolled in dental coverage, our highest starting numbers ever.
(I'm assuming that's a typo & should be 2024 health coverage, since obviously you can't have anyone enrolled in 2025 coverage prior to OEP launching).
Over 17,815 Nevadans Enroll Through Nevada Health Link in First Month of Open Enrollment Period
CARSON CITY, Nev. – Open Enrollment through NevadaHealthLink.com began on November 1, and Nevadans are taking action to secure their health coverage for the upcoming new year. In the first month, over 17,815 individuals have actively shopped for and enrolled in plans, demonstrating a strong start to this year’s enrollment period.
Among these enrollees, 7,270 are new to Nevada Health Link, a 10% increase in the number of new enrollees compared to the same period last year. Additionally, 10,545 consumers actively re-enrolled or updated their plans for 2025. In total, Nevada Health Link now provides coverage to over 95,000 Nevadans.
