New federal data show Affordable Care Act enrollment dropped 13% from last year, with analysts pointing to higher premium costs after enhanced subsidies ended.
By yourNEWS Media Newsroom
Affordable Care Act enrollment fell by about 3 million people in February compared with the same month last year, according to newly released federal data, marking a sharp decline for the government’s subsidized health insurance marketplace.
The U.S. Department of Health and Human Services report, released Friday, showed 19.2 million people had ACA plans in February, down from 22.1 million in 2025. The drop represents a 13% decline.
Federal officials suggested the decrease may be tied to a crackdown on fraudulent or “phantom” enrollment. Health policy analysts, however, said the larger factor was likely the Jan. 1 expiration of federal subsidies that had helped lower premiums for marketplace customers.
The end of those subsidies caused plan costs to rise for many enrollees, leaving some unable to make their first premium payments of the year.
“We know that real people lost their health insurance coverage,” said Cynthia Cox, a vice president and director of the ACA program at the healthcare research nonprofit KFF, citing survey findings on people who had left their plans. “This coverage loss happened at the same time millions of people faced double or even triple digit increases in their premium payments.”
The newly released data were compiled in April but reflect enrollment in February. The figures provide the government’s first official look at how nonpayment affected marketplace participation after the grace period for missed first payments expired.
An earlier federal estimate in January showed about 800,000 fewer people had selected ACA plans compared with the same point last year. That marked the first time in four years that enrollment was down from the previous year at that stage of the open enrollment period.
Cox said KFF expects ACA enrollment to keep falling throughout the year and could eventually drop to about 17.5 million.
Such a decline would represent a significant contraction for the federal healthcare program, which serves working-age people who do not qualify for Medicaid and do not receive health coverage through an employer.
In recent years, ACA marketplace plans have become an important source of insurance for gig workers, farmers, ranchers, hairstylists and others who lack employer-sponsored coverage.
The subsidy expiration followed a contentious congressional fight last fall. Democrats and some Republicans had called for the enhanced subsidies to be extended, warning that premiums would rise sharply if Congress allowed them to lapse.
The enrollment decline comes as health costs are increasing across ACA plans and other insurance programs. Affordability is also expected to remain a major issue for voters heading into the November elections.
The February figures show the first measurable impact of the subsidy expiration on coverage totals, while the debate continues over whether the decline reflects anti-fraud enforcement, rising premiums or both.
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