Registration to Obamacare plans it appears headed for a decline of more than 1 million Americans by 2026 amid an increase in monthly premiums and the expiration of enhanced federal subsidies for health insurance premiums that were implemented during the COVID-19 pandemic.

The Centers for Medicare and Medicaid Services (CMS) released a report Wednesday showing that 23 million consumers signed up for individual health insurance coverage through the Marketplaces during the 2026 open enrollment period. That included 15.8 million selections in states using the HealthCare.gov platform and 7.2 million using state-based exchanges.

The enhanced COVID-era subsidies for health insurance expired at the end of last year after Congress failed to agree on an extension, though the original subsidies implemented under the Affordable Care Act remain in place. Total premium costs for subsidized Obamacare enrollees are expected to rise to an average of $1,904 by 2026 from $888, according to KFF data.

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An analysis by healthcare industry research firm KFF noted that in mid-January, enrollment fell by about 1.2 million consumers compared to 24.2 million who had signed up at this point last year.

Congress failed to reach a deal to extend enhanced COVID-era subsidies for Obamacare plans. (Anna Moneymaker/Getty Images)

KFF noted that the enrollment data released at this stage represents automatic renewals and plan selections, which do not necessarily translate into completed enrollments, as some may choose not to pay for their plan.

More than four in 10 registrations by 2025 were for automatic renewals, and KFF explained that as returning consumers get their initial invoices from insurers and see the cost, they may choose not to pay the premium and eventually lose coverage or opt out.

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Health insurance costs are projected to increase in 2026. (Getty Images)

The group warned that without the enhanced premium tax credits, the premium take-up or payment rate could fall compared to previous years, which could result in the final enrollment data shows a deeper drop.

KFF conducted a survey that indicated premium payments were expected to more than double on average by 2026, and about 25 percent of enrollees said they would give up health insurance this year if their premiums doubled as expected.

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Obamacare enrollment numbers won’t be finalized until after the 90-day grace period for paying premiums has expired. (Matt McClain/The Washington Post via Getty Images)

Analysts said they expect total enrollment in Obamacare plans to decline in the coming months as consumers see higher premiums and choose to let their coverage lapse rather than pay significantly more to keep their coverage.

“Given the 90-day grace period, which should apply to most ACA members, we see potential for strong cancellation activity during this period, leading to lower final enrollment numbers,” said Evercore ISI analyst Elizabeth Anderson.

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HealthCare.gov enrollment ran until January 15, 2026, although enrollment deadlines for state exchanges vary.

Reuters contributed to this report.