As consumers face decreased access to Marketplace health insurance subsidies for 2026 plans – and higher net premiums for consumers who continue to be subsidy-eligible – one clear buying trend has emerged: a migration of buyers to Bronze-level health plans.
While details about the plans that people selected for 2026 are not yet available in most states, several state-run Marketplaces have published this information in early 2026. Data from those state-run exchanges shows a significant number of enrollees have downgraded their coverage, opting for a Bronze plan instead of a Gold or Silver plan.
What’s happening with Marketplace health plan enrollments?
Enrollment in Marketplace health plans declined in 2026 after four consecutive years of record-high enrollment. This was not surprising, given the sharp increase in net premiums for 2026 due to the expiration of federal subsidy enhancements at the end of 2025.
We don’t yet have Marketplace metal-level plan selection data for the states that use HealthCare.gov, but about half of the state-run Marketplaces have shared information about the metal levels that people selected during open enrollment. In most cases, Bronze plan selections increased significantly. (There were a couple of exceptions, which we’ll discuss in a moment.)
Why might consumers be downgrading to Bronze plans?
Lower premiums
Although all Marketplace plans cover the ACA’s essential health benefits, Bronze plans have higher deductibles and out-of-pocket limits than Silver or Gold plans. As a result, Bronze plans have lower monthly premiums.
So when consumers were faced with average net premiums that more than doubled for 2026, it’s understandable that people may have selected a different plan with a lower premium, in an effort to keep their monthly premium costs affordable.
Access to HSA contributions
The fact that Bronze plans are newly HSA-eligible may also have been a factor in some enrollees’ decisions to downgrade to a Bronze plan. As of 2026, all Bronze (and Catastrophic) Marketplace plans are HSA-eligible, meaning that people who enroll in these plans have the option to contribute pre-tax money to a health savings account (HSA).
Learn more about health savings accounts and the tax advantages they offer.
Contributions to an HSA will reduce the ACA-specific modified adjusted gross income (MAGI) that’s used to determine Marketplace subsidy eligibility. So selecting an HSA-eligible plan and making HSA contributions is a way for people to increase their subsidy amount (due to their reduced MAGI) or potentially qualify for subsidies if the HSA contribution brings their MAGI down below 400% of the federal poverty level (FPL).
This became more important in 2026, due to the return of the “subsidy cliff.” Enrollees with household income above 400% of FPL have to pay full-price for their coverage in 2026, so opting for a Bronze plan and contributing to an HSA may have been a choice that allowed some enrollees to continue to qualify for a subsidy.
Which state-run Marketplaces have reported an increase in Bronze plan selections?
Of the state-run Marketplaces that have published 2026 enrollment metrics thus far, all but two have reported an increase in the percentage of enrollees selecting Bronze plans:
California: Of enrollees in 2025 plans, 130,000 enrollees switched to Bronze plans for 2026. And among new enrollees, more than a third selected Bronze plans, compared with fewer than a quarter last year.
Idaho: Nearly 60% of enrollees picked Bronze plans, while enrollment in Silver and Gold plans declined compared to 2025 enrollment.
Maine: Nearly 60% of enrollees picked Bronze plans – up from 46% in 2025. (The percentage of enrollees in Bronze plans had been quite steady from 2022 through 2025.)
Maryland: The exchange reported that 5,743 people switched from 2025 Gold plans to Bronze plans for 2026.
New Jersey: Among people who actively selected a plan (not counting auto-renewals), 31% chose a Bronze plan, up from 16% the year before.
Pennsylvania: Bronze plan selections were 30% higher than they were the year before.
Rhode Island: As of mid-January 2026, about 38% of new enrollees had picked a Bronze plan, up from about 15% in previous years. There was also a trend of existing enrollees switching to Bronze plans at that point.
Vermont: Almost twice as many people newly selected a Bronze plan for 2026, compared with 2025. And more than 60% of the new Bronze enrollees had previously been enrolled in Gold plans.
Virginia: Bronze plan selections increased, although not as significantly as they did in most of the other states listed above. For 2026 coverage, 42% of enrollees selected Bronze plans, up from 38% in 2025.
Four of those nine states (California, Maryland, New Jersey, and Vermont) offer state-funded subsidies in addition to federal subsidies, in an effort to make Marketplace coverage more affordable. But despite this additional assistance, a significant number of enrollees still downgraded their coverage for 2026.
Which state-run Marketplaces reported a reduction in Bronze plan selections?
Two state-run Marketplaces have reported a decrease in Bronze plan selections for 2026. In both cases, the state had taken action to make more robust coverage more affordable for residents:
New Mexico
Very few Marketplace enrollees in New Mexico have Bronze plans. Enrollment in Bronze plans dropped slightly – from 3.4% in 2025 to 3.1% in 2026.
New Mexico offers additional state-funded subsidies that result in robust “Turquoise” plans being available to enrollees with household incomes up to 400% of the federal poverty level. These are by far the most popular plans in the New Mexico Marketplace, selected by nearly eight out of ten enrollees buying 2026 plans.
New Mexico is also the only state that used state funding to fully backfill the reduction in federal premium subsidies for 2026. So while consumers in many states responded to higher net premiums (stemming from the expiration of the federal subsidy enhancements) by downgrading their coverage to a plan with a lower premium, there was no need for New Mexico residents to do that.
Washington
About 87,000 Washington Marketplace enrollees selected Bronze plans for 2026, versus about 96,000 who had picked Bronze plans for 2025. (In both cases, this was roughly three out of ten enrollees, since total enrollment declined for 2026.)
But Gold plan selections increased significantly in Washington, increasing from 18% of plan selections in 2025 to 53% in 2026.
This migration to Gold plans happened because Washington adopted premium alignment for 2026, requiring insurers to add a 43% load to the premiums for Silver plans. This is because most Silver plans actually have benefits that are similar to those of Platinum plans, as a result of cost-sharing reductions (CSR).
Because Silver plans became more expensive, premium subsidies also increased, as subsidy amounts are based on the cost of a Silver plan. These larger subsidies made Gold plans more affordable, leading to a substantial increase in Gold plan selections for 2026.
What does a shift to Bronze plans mean for consumers?
Bronze plans have average deductibles of nearly $7,500 in 2026, which is more than double the overall weighted average deductible across all Marketplace plans. Plan designs vary considerably, but some Bronze plans count all non-preventive care toward the deductible (and deductibles can be as high as $10,600 in 2026, depending on how the plan is designed).
So consumers who select Bronze plans will generally have deductibles that are quite a bit higher than the average Marketplace plan deductible. Their total out-of-pocket exposure is often as high as the allowable maximum, which is $10,600 for a single individual in 2026. And depending on how the plan is designed, it might pay very little until the enrollee has met the deductible.
This means Bronze plan enrollees should be prepared for the possibility of having to pay several thousand dollars in out-of-pocket costs if they end up needing medical care during the year.
Unfortunately, a person who downgraded to a Bronze plan because of premium affordability might struggle to come up with the money to pay their deductible. Or they might avoid getting necessary medical care because of the cost.
Options for Bronze plan buyers facing higher out-of-pocket costs
If you’re enrolled in a Bronze plan and worried about higher out-of-pocket costs, there are several tips to keep in mind:
Comparison shop for your care whenever possible. Although your health plan might have a wide range of in-network hospitals, medical offices, and pharmacies, that doesn’t mean your out-of-pocket costs will be the same at all of them. If you need a prescription, you can check with various in-network pharmacies (including mail-order options) to see if there are price differences. The same is true for other medical care, and there are transparency tools that can help you determine what your costs will be.
Discuss your financial situation with your medical providers. You may find that they can offer a payment plan that fits within your budget.
If at all possible, consider opening and funding an HSA. All Bronze plans are HSA-eligible as of 2026. The money you contribute to an HSA is pre-tax. And if you need to use it to pay your deductible or other medical expenses, it will continue to be tax-free when you make the withdrawal. If you don’t end up needing to use the money in your HSA, it will remain in the account in future years until if and when you need it.
If your income isn’t more than 200% of the federal poverty level, you might be eligible for reduced out-of-pocket costs if you use a federally qualified health center (FQHC) that’s in your plan’s provider network. Depending on your income, these clinics can reduce the amount that you’d otherwise have to pay out-of-pocket under the terms of your health plan.
Consider supplemental coverage, such as a critical illness policy or an accident insurance policy, that could reimburse some of your out-of-pocket costs if you were to face unexpected medical costs for a covered illness or injury.
Some people with high-deductible health insurance choose to enroll in a local doctor’s direct primary care (DPC) membership program, to have unlimited access to various primary care services. And as of 2026, having a DPC membership no longer prohibits a person from making HSA contributions if they also have an HSA-eligible health plan, as long as the DPC membership meets certain parameters.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
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