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Healthcare Services: ACA Exchange (HIX) Market Contracted ~17% Since Close of 2026 OEP
研报英文原文证据摘录
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
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