ACA enrollment falls sharply nationwide after subsidy expiration

Federal data released in late June 2026 show that enrollment in the Affordable Care Act (ACA) marketplace dropped by about 13%, from 22.1 million in 2025 to 19.2 million in February 2026 – a loss of roughly 2.6 million people. The steepest declines occurred in Ohio and Oklahoma, each losing more than 32% of enrollees, with Arizona, South Carolina, Minnesota, Indiana, Michigan, Mississippi, Louisiana and Missouri also shedding over a quarter of their covered populations. By contrast, New Mexico increased enrollment by 14% after the state funded its own subsidies.

The primary driver was the January 1, 2026 expiration of the temporary “enhanced premium tax credits” that had lowered monthly premiums. Without the subsidies, average premiums for subsidized consumers more than doubled, rising from about $888 per month in 2025 to roughly $1,904 in 2026. The Department of Health and Human Services cited a crackdown on fraudulent or “phantom” enrollments as a partial cause, but health‑policy analysts attribute most of the loss to unaffordable premium hikes.

The enrollment drop has heightened concerns about health‑insurance affordability ahead of the November elections, as many who left the marketplace are likely without coverage.