Enrollment in the Affordable Care Act (ACA) health insurance marketplace has declined for the first time since 2020, as the expiration of enhanced federal subsidies leaves millions of Americans facing significantly higher monthly premiums.
For those who are left outside of the insurance system, or who are looking for alternatives to costly and ineffective policies, healthsharing programs are an increasingly popular option for many Americans.
New data from the Centers for Medicare & Medicaid Services (CMS) reveals that ACA sign-ups for 2026 are down by over 1 million people compared to the previous year. The decline is primarily attributed to the end of enhanced premium tax credits, which had been in place since 2021 to make coverage more affordable. Without these credits, subsidized enrollees staying in the same plans saw their premium payments increase by an average of 114%.
While the full scope of the decline will not be known until “effectuated” enrollment data—which tracks those who actually pay their first premium—is released later this year, early indicators point to a sharp contraction. In Pennsylvania, the state’s marketplace, Pennie, reported that roughly one-in-five enrollees dropped coverage for 2026 due to what officials termed “unprecedented cost increases.” Pennsylvania enrollees faced an average price hike of 102% to maintain their existing plans.
In Kentucky, enrollment fell to approximately 89,000, down from 97,000 the year prior. “Folks’ budgets change all the time, and health insurance is often the first thing that they drop,” said Priscilla Easterling, director of outreach for Kentucky Voices for Health.
Those who remained in the marketplace often sought relief by shifting to lower-cost, high-deductible “bronze” plans. In Pennsylvania, enrollment in bronze plans jumped by 30%. While these plans offer lower monthly premiums, they often carry deductibles exceeding $7,000, creating significant financial barriers to actual care. David Roode, a freelance musician in Kentucky, reported switching to a bronze plan after his premium tripled, only to be met with a $10,000 deductible.
The legislative path to restoring the subsidies remains blocked. While the U.S. House voted to extend the credits in January, negotiations in the Senate have collapsed. Senator Bernie Moreno (R-Ohio) stated recently that efforts to extend the subsidies are “effectively over.”
The Case for Healthsharing
As millions exit the traditional insurance market due to rising costs and complexity, some industry leaders argue the current system is fundamentally broken. Christopher Jin, president of WeShare by UHSM, recently contended that the ACA had failed to deliver on its promise of affordability, instead burdening Americans with “rising premiums, restrictive networks, confusing fine print, and complicated protocols.”
Jin suggests that for those leaving traditional insurance, Health Care Sharing Ministries (HCSMs) offer a viable, community-driven alternative. Unlike traditional insurance, healthsharing involves nonprofit, faith-driven organizations that facilitate member-to-member sharing of medical expenses.
“Healthsharing is not insurance; it’s something better,” Jin said, noting that the model focuses on community care rather than corporate profit. According to Jin, the traditional model is flawed because giant insurance companies and the government have “inserted” themselves into the doctor-patient relationship.
One of the primary advantages of healthsharing, according to UHSM, is the clarity of costs. Members make set monthly contributions that are shared to support the medical needs of others in the community. Jin notes that WeShare programs are designed for “flexibility and clarity,” with no hidden fine print or complex percentages to calculate.
Furthermore, Jin argues that healthsharing rewards personal responsibility. “Our members are rewarded for taking care of themselves with lower monthly contributions,” he said, adding that members still maintain access to a nationwide network of 1.2 million physicians.
Beyond emergency care, these programs often emphasize holistic and preventive health. WeShare, for instance, includes wellness visits at a $0 consultation fee and provides access to mental health services and telehealth. Jin views this as a way to put the “patient back in the driver’s seat” by negotiating inflated medical prices down to a “fair and just cost of care.”
A Growing Movement
The healthsharing sector currently includes an estimated 1.7 million Americans who collectively share over $1 billion in medical expenses annually.
To further stabilize this alternative, Jin is advocating for the Health Care Sharing Ministry Tax Parity Act currently before Congress. The legislation would allow healthsharing members to deduct their monthly contributions as medical expenses, a benefit currently reserved for traditional insurance premiums.
“Tax parity can help level the playing field,” Jin said, arguing it would give Americans the opportunity to “liberate themselves” from high premiums and high denial rates.
As the 2026 enrollment data continues to stabilize, the contrast between the shrinking ACA marketplace and the community-based healthsharing model is becoming a central point of the national healthcare debate. For many, the choice is no longer between different insurance tiers, but between a traditional system they can no longer afford and a faith-based community they are just beginning to explore.