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About 5 million drop ACA coverage as premiums rise

politicsJun 27, 202632193

New federal data and reporting show roughly 5 million fewer people are enrolled in Affordable Care Act marketplace plans for 2026 after enhanced premium subsidies expired on December 31, 2025. Enrollment was 19.2 million in February 2026, down from a record 23.1 million during open enrollment, with more than 1 million fewer people selecting plans for 2026 and about 4 million additional people disenrolling or failing to pay premiums. Analysts say the subsidy expiration produced big premium spikes, reports cite premiums more than doubling for as many as 22 million people, while Trump administration officials point to fraud as a factor in the surge of unpaid plans. Notus and other reporting found about 4 million people dropped ACA coverage in the first month of 2026 largely for failing to pay monthly premiums. Health policy experts and reporting emphasize payment affordability as the primary driver; one expert quoted said the drop cannot be explained by fraud and another noted people make decisions based on what they can pay each month. Federal watchers expect further coverage losses as higher monthly premiums and out‑of‑pocket costs accumulate through the year.

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