West Virginia Obamacare enrollments drop as premiums spike 

by Lori Kersey, West Virginia Watch
January 22, 2026

With monthly premiums spiking for many, about 10,000 fewer West Virginians signed up for health insurance coverage through the Affordable Care Act’s healthcare.gov marketplace this year compared to last, according to preliminary data released this week by the federal government.

As of the first week of January, 55,127 state residents had either enrolled or were automatically re-enrolled in health insurance plans on the health insurance marketplace. As of the same time in 2025, that number was 64,818, according to a spokesperson for the federal Centers for Medicare and Medicaid. 

Enhanced tax credits that made the plans affordable, expired Dec. 31, 2025, leading to a spike in the cost of premiums for 2026 plans. 

Ellen Allen, executive director of West Virginians for Affordable Health Care, said the nearly 15% drop in enrollment is unsurprising. 

“West Virginians simply can’t afford 200%, 300% and even higher premium increases,” Allen said. “It’s very unfortunate and we’ll likely see more people drop out who were betting on Congressional action in the new year.” 

According to an analysis by the West Virginia Center on Budget and Policy, West Virginia households of all sizes and incomes saw dramatic spikes in their monthly premiums for healthcare.gov plans. In some cases, the premiums for the same plan in 2026 increased tenfold. Households in the state on average saw their premiums increase by more than half, increasing by 133%. Older families and those who earn more than 400% of the federal poverty level were most impacted. The latter lost their subsidies altogether.

The enhanced tax credits were at the center of a congressional fight that led to a government shutdown that lasted more than a month last fall. Democrats in Congress wanted to extend the credits past their end-of-the-year deadline. Congress still has not reached an agreement to extend the tax credits.

Across the country, the number of people buying 2026 plans on the marketplace was down by about 833,000, according to reporting by States Newsroom. 

People had until Jan. 15 to sign up for 2026 plans on the Marketplace. Jeremy Smith, program director for First Choice Services, which runs the state’s Affordable Care Act navigator program, said most people sign up for plans before Dec. 15, which is required for coverage to begin on Jan. 1. On Dec. 16, people enrolled in plans last year are automatically re-enrolled in plans for the next year, he said. 

Smith said of the people First Choice Services helped enroll, about one in four people were dropping their plans. Another 25% switched their coverage to one with a higher deductible just so they could afford it to keep insurance, he said.

“A lot of people, they really had to dig in this year and make a hard decision whether they were going to keep it or whether they were going to switch into a plan that they could maybe make the monthly payment,” Smith said. “But then all of a sudden their deductibles and co-pays are way out of reach, too. But that’s kind of the trend that we saw as far as the people we helped.”

The enhanced tax credits were first made available through the American Rescue Plan of 2021 and extended through the Inflation Reduction Act to the end of 2025 

In a statement, Kelly Allen, director of the West Virginia Center on Budget and Policy, said state workers, business owners and families who rely on the marketplace had to make painful trade offs this year with the expiration of enhanced subsidies.

“Some are going without health insurance altogether while others are going without other basics to offset huge spikes in their premiums,” she said.

Allen said a fuller sense of the impact of the subsidies expiring will be known after West Virginia families make their first payments to make their plans effective. 

“All that said, we are hopeful Congress will take action to extend the enrollment period and reinstate these subsidies that make health insurance accessible and affordable for tens of thousands of West Virginians in time for the rest of 2026,” Allen said. 

West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.