If you buy your own health insurance, 2026 has felt more expensive than ever. You’re not imagining it. A new national analysis confirms what many self-employed Utahns are already experiencing: ACA marketplace enrollment is declining sharply, and the people hit hardest are middle-income earners who make too much to qualify for subsidies. If that describes your situation, exploring a better ACA alternative for self-employed individuals and families could be one of the most valuable financial conversations you have this year.
What’s Driving the Drop in ACA Enrollment
According to a May 2026 analysis from KFF, a nonpartisan health research organization, nationwide ACA marketplace enrollment is projected to fall by nearly 5 million people this year. That’s a drop from 22.3 million enrollees in 2025 to roughly 17.5 million in 2026 — a decline of more than 20%.
The primary driver is the January 1st expiration of enhanced premium tax credits. These were temporary subsidies introduced during the COVID pandemic that helped keep marketplace premiums manageable for millions of Americans. Congress considered extending them last year but couldn’t reach a deal. When the subsidies expired, premiums jumped by an average of 58%.
To cope, many enrollees downgraded to lower-premium plans with much higher deductibles. Average deductibles rose by more than $1,000 — a record-setting single-year jump. As KFF vice president Cynthia Cox put it: “No matter how you slice it, people are paying more.”
Who’s Hit Hardest: Self-Employed, Middle-Income Families
Here’s the detail that matters most if you work for yourself. KFF found that middle-income Americans dropped ACA coverage at a higher rate than other income groups. They earn too much to qualify for the remaining income-based subsidies but not enough to absorb a 58% premium hike without feeling the strain.
The ACA’s premium tax credits phase out above a certain income threshold. If you’re a freelancer, contractor, or small business owner earning above that line, you pay full price. In recent years, the enhanced subsidies softened that reality. Now that they’re gone, many self-employed individuals are asking a fair question: is the marketplace still the right fit for me?
For healthy, middle-income individuals and families with no high-risk pre-existing conditions, that question often leads to the same answer — it’s time to seriously look at an ACA alternative for self-employed coverage.
ACA Alternatives for Self-Employed Utahns: What Are Your Options?
There are solid ACA alternatives for self-employed Utahns worth knowing about. At Groberg Insurance Advisors, we help individuals and families explore a full range of health insurance options — including plans that exist completely outside the ACA system.
Marketplace (ACA) plans still make sense for the right person. If you have pre-existing conditions that require guaranteed coverage, or if your household income qualifies you for meaningful premium tax credits, the marketplace may still be your best path. Our ACA Marketplace Health Insurance page walks through exactly who benefits most from these plans, how the subsidy system works, and what the enrollment process looks like with expert guidance.
Private, or non-ACA, health insurance is worth a serious look for people who don’t qualify for subsidies and have no significant pre-existing conditions. These plans are purchased directly from insurance carriers — completely outside the ACA. They operate under different underwriting rules and pricing structures, and can offer meaningfully lower monthly premiums for the right person. In some cases, we’ve helped clients save 40–60% on their monthly premium by switching to a private plan. Our private health insurance page explains how these plans work, who qualifies, and what to watch for during the selection process.
One important advantage of most private plans: they are not restricted to the annual open enrollment period. That means you may be able to make a change now — without waiting until the end of the year.
Is It Time to Reconsider Your Coverage?
Not everyone should leave the marketplace, and we’d never suggest that without reviewing your specific situation. The right answer depends on your income, your family’s health history, and what you’re currently paying.
That said, if you’re self-employed, generally healthy, and earning above the subsidy threshold, there’s a real chance you’re overpaying. The numbers from 2026 are hard to ignore: premiums are up, deductibles are at record highs, and millions of Americans have already stepped away from the marketplace. Understanding your ACA alternatives as a self-employed individual, and what they’d actually cost you, is simply good financial sense.
The health insurance landscape shifted meaningfully this year. Whether the marketplace still fits your situation or a private plan makes more sense, the only way to know is to compare your options with someone who understands both sides of the equation.
If you feel like you’re paying too much for health insurance, or you just want a second opinion on your current plan, book a free appointment with Groberg Insurance Advisors. We’ll review your situation, walk through your options, and give you a straight answer. No pressure, just good information.
