Final 2026 Open Enrollment Report: New vs. Renewals (Part 2)

Now it's time to move on to the actual demographic breakout of 2026 Open Enrollment Period (OEP) Qualified Health Plan (QHP) enrollment.

First up: Breaking out new enrollees vs. existing enrollees who either actively re-enroll in an exchange plan for another year or who passively allow themselves to be automatically renewed into their current plan (or to be "mapped" to a similar plan if the current one is no longer available).

Nationally, 15.6% of all exchange QHP enrollees were new this year. The other 84.4% are current enrollees who signed up for another year.

Fortunately, more enrollees took my advice and actively re-enrolled this year (46.3% vs just 39% last year). Unfortunately, 38.1% still allowed themselves to be passively auto-renewed. Those are the ones who, in many cases, were likely hit with massive sticker shock as they were auto-renewed into a plan which probably had dramatically higher premiums due to the enhanced tax credits expiring...over 8.8 million enrollees nationally.

Vermont had the lowest percent of new enrollees this year (8%), while Rhode Island had the highest at 22.6%.

As I've noted before, there's still a massive divide between federal and state-based exchanges when it comes to active renewals: Over 52% of federal exchange states actively renewed (which is good!)...but only 33% of state-based exchange enrollees did. Active renewals range from just 9% in DC to 66% in Utah.

Again, nationally, 45% of those renewing this year (38% of all enrollees) did so automatically...that is, they took no action whatsoever.