At a Glance
- The monthly cost of ACA insurance for many has jumped, pushing them to switch to lower-premium Bronze plans.
- Bronze plans have the lowest premiums but the highest deductibles, with an average annual deductible of $7,500.
- New enrollments in Bronze plans rose sharply, with 38% in Rhode Island and over a third in California.
- Why it matters: Choosing a bronze plan may save money each month but can leave families facing huge out-of-pocket bills if they need care.
The decision for many Americans to shift to the cheapest option on the ACA marketplace has taken a dramatic turn. For Kate Bivona, a 37-year-old musician in Arizona, the monthly premium for her health plan climbed by about $300 in January, forcing her and her husband to downgrade to a bronze plan. While the new plan cuts their bill in half, it also locks them into an $18,000 annual deductible.
Why Bronze Plans Are Rising
The trend toward bronze plans is largely a reaction to the expiration of enhanced premium tax credits at the end of last year. When those subsidies ended, many people found that the higher monthly costs of silver plans were no longer affordable.
“People are feeling very price sensitive,” said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, the state’s ACA marketplace. “The expiration of the enhanced premium tax credits is putting a lot of people in a position where they’re kind of barely able to hang on in terms of affording coverage.”
ACA plans are sold in four main tiers:
- Bronze – lowest premiums, highest deductibles
- Silver – moderate premiums, moderate deductibles
- Gold – higher premiums, lower deductibles
- Platinum – highest premiums, lowest deductibles
The shift marks a sharp break from past years, when most people gravitated toward silver plans that balance higher monthly premiums with lower deductibles.
What Bronze Plans Mean for Enrollees
Bronze plans cover the core benefits required by the ACA, including annual physicals, well-woman visits, cancer screenings and prescription drugs. Because they are the lowest tier, they often require enrollees to pay thousands of dollars out of pocket before other coverage kicks in.
The average annual deductible for a bronze ACA plan in 2026 is roughly $7,500 for an individual, according to KFF, a nonpartisan health policy research group.
“The idea of the bronze plan was that it would appeal to younger, healthier people,” said Cynthia Cox, director of the program on the ACA at KFF. “You could get a lower premium, you would potentially have a higher out-of-pocket cost, but only if you had a significant health care expense.”
Bivona and her husband fit that profile. Both are young and generally healthy, and she mostly uses her insurance for medications and the occasional doctor’s appointment.
“It makes me so angry,” she said.
State-by-State Trends
Data from state marketplaces show the most pronounced shift in Rhode Island and California. In Rhode Island, as of early January, 38% of new enrollees had selected bronze plans for 2026, up from 15% two years earlier. Silver fell from 53% to 35% and gold dropped from 31% to 25%.
“Bronze plan selection is up significantly and silver and gold selection is down significantly for new customers,” wrote Christina Spaight O’Reilly, communications director for Rhode Island’s ACA marketplace, in an email.
In California, more than a third of new ACA enrollees chose bronze plans for 2026, up from about 1 in 5 last year. Nearly three-quarters of renewing customers who switched plan tiers also moved to bronze coverage.
Other states such as Kentucky, Idaho, Massachusetts, New York and Virginia reported an increase in plan switching, with many enrollees moving to cheaper options. Data for Arizona, where Bivona lives, isn’t yet available because it’s federal.
| State | Bronze % (2026) | Silver % | Gold % |
|---|---|---|---|
| Rhode Island | 38% | 35% | 25% |
| California | ~33% | – | – |
| Kentucky | – | – | – |
| Idaho | – | – | – |
| Massachusetts | – | – | – |
| New York | – | – | – |
| Virginia | – | – | – |
Initial federal open enrollment data shows Obamacare sign-ups are down more than 800,000 from last year. The federal data hasn’t yet broken down which plans people selected, leaving state data as the clearest picture of how coverage choices are changing.
Potential Risks
Health policy experts warn that a broad move toward bronze plans could lead more people to delay care, skip treatment or take on debt to pay for medical expenses-even though they technically have health insurance.
“If a person suffers from chronic disease or experiences a health emergency, these high-deductible plans push people into bankruptcy,” said Larry Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University. “Also, with high deductibles, many people will hesitate to go for diagnosis and treatment. These delays can make patients sicker or even cause deaths.”
The change in plan selections stems from the expiration of the enhanced ACA subsidies at the end of last year, which pushed premiums higher and forced many people to prioritize monthly costs over more comprehensive coverage.
Looking Ahead
Even without the cash to meet a high deductible, Cox of KFF said, it’s better to remain insured than to go without coverage altogether.
“Even without the cash to meet a high deductible, the coverage can still protect people from catastrophic medical bills, such as cancer treatment or serious injuries from a car accident,” she said.
The people switching to a bronze plan this year may start to feel like they might as well be uninsured,” Cox added.
Key Takeaways
- Many Americans are choosing the cheapest ACA option because monthly premiums have risen.
- Bronze plans have the lowest premiums but the highest deductibles, which can create financial strain when care is needed.
- State data shows a sharp increase in new bronze plan enrollments, especially in Rhode Island and California.
- Health experts warn that high deductibles can lead to delayed care and financial hardship.
- Staying insured, even with a high deductible, still protects against catastrophic medical costs.
