Healthcare Services: ACA Exchange (HIX) Market Contracted ~17% Since Close of 2026 OEP

Research evidence excerpt

Healthcare Services: ACA Exchange (HIX) Market Contracted ~17% Since Close of 2026 OEP

Equity Research

29 June 2026 | 2:34PM EDT

Healthcare Services: ACA Exchange (HIX) Market Contracted ~17% Since

Close of 2026 OEP

On June 26, 2026, the U.S. Department of Health and Human Services (HHS) Scott Fidel

+1(212)902-7304 | scott.fidel@gs.com

released an updated assessment of ACA Exchange (HIX) enrollment and program Goldman Sachs & Co. LLC

integrity trends, showing total effectuated enrollment of 19.2 million as of February Sarah Conrad

2026, down from February 2025 enrollment of 22.1 million (~13% Y/Y decline) (link), +1(212)357-2448sarah.conrad@gs.com|

and down 3.8 million members (~17% YTD decline) from 23.0 million sign-ups at the Goldman Sachs & Co. LLC

Valentine Vlasovconclusion of the 2026 OEP (link). Despite this step-down, the current HIX market +1(212)934-0210 |

enrollment base is still nearly 2x larger than the pre-COVID baseline of ~10.4 million valentine.vlasov@gs.comGoldman Sachs & Co. LLC

in 2019, reflecting the sustained impact of enhanced subsidies and other favorable

policy changes implemented during the previous 5 years.

In this latest update, HHS estimates that ~13% of HIX market enrollment as of

February 2026 represents improper or phantom members, which the current

administration remains focused on eliminating since the One Big Beautiful Bill Act

(OBBBA). Per the HHS assessment of the ~8.8 million members added to the HIX

market since 2019 (10.4 million in 2019 to 19.2 million in 2026), ~6.1 million of this

member growth reflects legitimate underlying coverage gains, while ~2.6 million of

these gains (~13% of February 2026 enrollment) remain potentially improper or

phantom enrollment even after recent remediation efforts. Following the current