Different State Policies Reflected in 2026 Health Insurance Marketplace Enrollment

In a previous post, we explored how Arkansas consumers navigated the 2026 health insurance marketplace open enrollment period amid large and complex increases in premiums. While marketplace plan premiums increased nationwide in 2026, consumers were faced with very different circumstances in each state. This post compares the experience of Arkansas consumers in the 2026 open enrollment period to that of consumers in peer states.

Changes in Overall Premiums, Pre- and Post-Subsidy

In an installment of our Data Watch series published in February, we noted that while Arkansas had the greatest increase in benchmark premiums of any state in 2026, this was part of an insurer pricing strategy known as “silver loading,” in which premium increases are concentrated in benchmark silver plans. Because federal premium subsidies are calculated based on the benchmark premium, increasing silver plan premiums leads to larger federal subsidies for qualifying consumers. As a result, Arkansas’s average premiums before application of federal premium subsidies increased relatively sharply, but the average post-subsidy, out-of-pocket premium cost to consumers increased by relatively little compared to nearby states. The interactive map below illustrates this pattern:

Among the 10 states shown, Arkansas had the largest percentage increase in its statewide average pre-subsidy premium, but the smallest percentage increase in its average post-subsidy premium — which reflects the cost paid by consumers. That said, Arkansas’s average post-subsidy premium remained relatively high at $162 — the third-highest of the 10 states included in this comparison.

Shift in Metal Tier Enrollment: Arkansas vs. Nearby States

As discussed in our previous post on consumer shopping behavior in the 2026 open enrollment period, premiums vary widely between consumers within a state, primarily depending on income and metal level selection. Consumers in different states faced different marketplace circumstances, depending on what policy actions their states took to control rising health insurance costs.

In Arkansas, consumers shifted substantially from silver plans to gold plans. For silver plan enrollees with incomes that qualify them for little or no federal cost-sharing reductions, moving to a gold plan likely meant reduced cost-sharing exposure for little or no extra cost. For those who do qualify for cost-sharing reductions, the move to a gold plan likely meant higher cost-sharing exposure. However, for both groups, the shift to gold plans was a more favorable outcome than the swing toward low-premium, high-cost-sharing bronze plans seen in many peer states. The graphic below compares metal tier plan selections as a percentage of total marketplace enrollment in Arkansas and a selection of nearby states.

Arkansas and Texas experienced substantial growth in the proportion of enrollees who selected gold plans for 2026. Texas law has effectively required silver loading since 2023, so its enrollment in gold plans was already high in 2025. By implementing similar pricing dynamics, Arkansas saw a similar metal tier enrollment pattern in 2026. The other six states included did not implement silver loading to the same extent in 2026. In those states, movement was primarily from silver to bronze plans, which generally have higher cost sharing regardless of consumers’ income levels.

Effects of Differing Policy Approaches

Some states took a more direct approach to reducing the cost of coverage for marketplace consumers as the enhanced premium tax credits expired at the end of 2025. New Mexico went farther than most states by using state funds to cover the expired federal subsidies in full for nearly all enrollees. Other states, such as Colorado, partially covered the credits for some enrollees.

New Mexico appropriated $22.3 million in general funds and an additional $17.3 million in emergency funds largely to continue the enhanced advance premium tax credits in full. The state experienced substantial growth in overall enrollment and saw a greater share of consumers selecting silver plans and a reduced share selecting gold plans. New Mexico already had disproportionately high enrollment in gold plans in 2025, partly because New Mexico, like Texas and Colorado, had implemented substantial silver loading prior to 2025. The shift from gold to silver may reflect in part an influx of new enrollees selecting New Mexico’s unique “turquoise plans” — a set of three marketplace plans (two silver and one gold) available since 2024 that use state subsidies to reduce cost sharing for eligible consumers. For lower-income consumers, these plans offer strong cost-sharing protections relative to their premiums and draw enrollment to the silver and gold metal tiers…

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