Fewer Oregonians are enrolling in marketplace plans because of federal uncertainty

The Oregon Health Authority on Thursday released its annual report giving insight into what enrollment rates are for the state’s health insurance exchange and explaining why those rates are changing.

The Oregon Health Insurance Marketplace offers financial assistance and coverage guidance for those who don’t receive health insurance through their employer, Medicare, the Oregon Health Plan or Veterans Affairs. Self-employed people, part-time workers or employees of smaller businesses that don’t offer health insurance typically use the marketplace. 

About 118,400 people during open enrollment enrolled in marketplace health insurance for 2026, 15% less than the nearly 140,000 people who enrolled in 2025.

The report attributed that drop to the expiration of the pandemic-era enhanced premium tax credit, which means more Oregonians purchasing marketplace coverage are now facing higher premiums. In 2026, people paid an average of $426 in monthly premiums after financial assistance, a surge from an average of $272 in 2025. The higher premiums are influencing people’s decision on whether to enroll at all or downgrade to a plan with higher-out-of-pocket costs, according to the report.  

Federal policy changes after President Donald Trump signed last summer’s sweeping congressional tax and spending law  have also affected enrollment. The law he signed in July 2025 increased documentation requirements to access Medicaid and Affordable Care Act programs. 

And as of August, people who came to the U.S. as children and are enrolled in the Deferred Action for Childhood Arrivals program are no longer eligible for Marketplace coverage. Disenrollments took place in October. The state directed affected individuals to alternative coverage options, such as Healthier Oregon, a Medicaid-like program that is primarily state-funded.

Among Oregonians enrolled in marketplace plans, the largest share, or 38% of enrollees, are people ages 35 to 54. They are followed by people ages 55 and older at 34%, adults ages 18 to 34 at 18% and individuals under age 18 at 10%, according to the report.

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