BY MIRABEL ODETA
Millions of Americans are facing growing financial pressure as healthcare costs continue to rise across the United States, leading to a sharp increase in the number of people dropping or losing their Obamacare health insurance plans due to unpaid premiums.
New data from several states that operate their own Affordable Care Act marketplaces shows that significantly more people are being removed from coverage compared to previous years. The trend is emerging as a major political concern for President Donald Trump and Republican lawmakers ahead of the November midterm elections, where the affordability of healthcare is expected to become one of the defining issues for voters.
The Affordable Care Act, originally signed into law under former President Barack Obama, has provided health insurance coverage for millions of Americans who do not receive insurance through employers or government programs. However, recent changes to federal subsidies and rising insurance premiums are placing growing strain on consumers, especially middle-income families and residents in rural states.
According to enrollment figures, approximately 23 million Americans either signed up for or were automatically reenrolled in Obamacare plans for 2026. That represents a decline of around 5% from the previous year. Analysts say the decrease is largely connected to the expiration of enhanced federal subsidies introduced during the COVID-19 pandemic, which had temporarily lowered healthcare costs for many families.
Without those additional subsidies, annual premiums increased dramatically. Research from healthcare policy organization KFF found that average yearly premium costs rose by roughly 114%, reaching nearly $1,905 annually for many consumers.
As prices climbed, many Americans found themselves unable to keep up with monthly payments. Policy experts say this is causing a growing number of people to abandon coverage altogether.
“Consumers are now seeing the real, unsubsidized price of health insurance plans and many are deciding they simply cannot afford to stay enrolled,” said KFF policy analyst Matt McGough.
The situation has become especially severe in several states. Kentucky reported one of the sharpest increases in coverage losses. Between January and April, more than 15,000 people lost their insurance due to non-payment, compared to just over 5,000 during the same period last year. State officials also confirmed that overall enrollment dropped by more than 8%.
Idaho experienced a similarly dramatic shift. Enrollment there declined by more than 24,000 people, significantly worse than the losses recorded during the same timeframe a year earlier.
Other states also reported rising numbers of residents failing to pay their premiums or leaving the marketplace because of affordability concerns. Connecticut, Massachusetts, New Mexico, and Maryland all reported thousands of canceled policies linked to unpaid insurance costs.
Healthcare experts warn that the problem may worsen throughout the year as inflation, rising fuel prices, and broader economic uncertainty continue affecting household budgets.
Jonathan Oberlander, a health policy professor at the University of North Carolina School of Medicine, described healthcare affordability as one of the most politically dangerous issues facing lawmakers this election season.
He warned that the impact could build gradually over the coming months “like a gathering storm” as more Americans lose coverage and public frustration grows.
Public opinion surveys suggest healthcare costs remain one of the top concerns for voters nationwide. Polling from KFF shows affordable healthcare ranks alongside rising gasoline and transportation expenses as one of the biggest worries for Americans heading into the elections.
Independent voters, who are expected to play a major role in deciding control of Congress, appear especially focused on healthcare affordability. More than three-quarters of independents surveyed said healthcare costs would influence both whether they vote and which political party they support.
Analysts believe states with limited competition among insurance providers may be experiencing larger enrollment declines. Rural states such as Kentucky and Idaho generally have fewer insurers participating in Obamacare marketplaces, which can result in higher prices and fewer affordable options for consumers.
Kentucky officials confirmed that the number of insurers participating in the state marketplace fell from four in 2025 to three in 2026, reducing competition even further.
Some states have managed to soften the impact through additional local financial support programs. Colorado and Pennsylvania reported relatively smaller enrollment declines of around 2%, partly because state-based assistance helped lower costs for residents.
Maryland officials also reported mounting financial strain among consumers. Michele Eberle, executive director of Maryland’s Health Benefit Exchange, said enrollment in the state had already fallen by 8%, and more than 60% of people who left coverage cited rising or unmanageable costs as the primary reason.
Maryland expects enrollment to decline by as much as 15% by the end of the year if current trends continue.
“We’re going to keep seeing monthly declines, especially as gas prices continue rising,” Eberle said. “The big question is where the breaking point will be for families trying to afford coverage.”
Meanwhile, healthcare consulting firm Wakely Consulting Group estimated that total Obamacare enrollment may have already fallen between 17% and 26% through March based on payment data covering most of the individual insurance market.
The firm also reported that more than 14% of enrollees failed to pay their January premiums, reinforcing concerns that affordability challenges are rapidly growing nationwide.
As the midterm elections approach, both Republicans and Democrats are expected to intensify their focus on healthcare policy, insurance costs, and economic pressures facing ordinary Americans. With millions potentially losing coverage or struggling to maintain insurance, healthcare affordability is shaping up to be one of the central political battles of the year.
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