US Obamacare Enrollment Drops as Subsidies End, Sparking HSA Debate

A Public Citizen analysis of government data found that enrollment in the Affordable Care Act marketplace fell from 22.3 million in 2025 to an estimated 17.5 million in 2026 after Congress allowed the enhanced premium tax credits to expire. The report says the decline was driven by subsidy cuts, not the removal of fraudulent enrollees, noting that “the people losing coverage are concentrated at incomes well above the poverty line,” according to research director Peter Whoriskey.

With millions of low‑ and middle‑income families now uninsured, policymakers are debating whether expanding health‑savings accounts (HSAs) could improve affordability. Proponents argue HSAs give taxpayers pre‑tax funding and more control over medical spending, while critics contend the accounts mainly benefit wealthier individuals who can afford to contribute and that they do little for lower‑income patients.