Millions drop Obamacare health plans after subsidies expire and costs rise

June 27, 2026 - 23:00

New federal data reveals a sharp decline in Affordable Care Act enrollment, with roughly 3 million fewer people holding ACA health insurance plans this February compared to the same month last year. The drop follows the expiration of enhanced subsidies that had made coverage more affordable during the pandemic.

The figures, released by the Centers for Medicare and Medicaid Services, show that about 20.4 million people were enrolled in ACA plans as of February, down from 23.4 million a year earlier. The steepest losses occurred in states that did not expand Medicaid, where lower-income residents faced the biggest premium increases after the subsidies lapsed.

Insurance brokers and patient advocates report that many individuals simply could not afford their monthly payments once the temporary financial help ended. Some families saw their premiums double or triple, forcing them to either drop coverage or switch to cheaper plans with higher deductibles and fewer benefits.

The enrollment decline comes at a time when the Biden administration has touted record ACA sign-ups during open enrollment periods. However, those numbers did not account for people who later failed to pay their premiums or let their policies lapse when the subsidies ran out.

Health policy experts warn that the loss of coverage could lead to worse health outcomes and higher uncompensated care costs for hospitals. Without insurance, people are less likely to seek preventive care or manage chronic conditions, which often results in more expensive emergency treatments later.

Some states have stepped in with their own subsidies to cushion the blow, but most have not. The future of the ACA marketplaces remains uncertain as Congress debates whether to restore the enhanced subsidies or let them remain expired.