ACA Enrollment Drops 1.2 Million as Expired Subsidies Drive 58% Premium Jump
Updated
Updated · POLITICO · May 19
ACA Enrollment Drops 1.2 Million as Expired Subsidies Drive 58% Premium Jump
11 articles · Updated · POLITICO · May 19
About 1.2 million people had already dropped Affordable Care Act coverage by March, early federal data shows, with KFF projecting total marketplace enrollment could fall nearly 5 million this year to 17.5 million.
The decline follows Congress letting enhanced ACA subsidies expire, pushing average premiums up 58% and leading many enrollees to fall off coverage midyear when they cannot keep paying.
Average deductibles rose 37%—more than $1,000—to $3,387 for 2026, while bronze-plan selections climbed to 40% of all marketplace sign-ups and silver-plan enrollment fell 57% to an all-time low.
Trump administration officials, including CMS Administrator Mehmet Oz, have downplayed the subsidy impact and argued much of the coverage drop reflects a crackdown on fraudulent enrollments.
The affordability squeeze lands as both parties sharpen health-care messages ahead of the midterms, with critics warning cheaper high-deductible plans can leave consumers exposed to larger out-of-pocket costs.
As premiums double for many, is the insurance marketplace approaching a tipping point for middle-income households?
With millions priced out of health plans, what everyday essentials are American families now forced to sacrifice?
2026 Health Insurance Shock: ACA Marketplace Loses 30% of Enrollees Amid Premium Spike and Policy Changes
Overview
In 2026, health insurance coverage through the ACA Marketplace dropped sharply as enhanced federal subsidies expired, leading to substantial premium hikes. After grace periods ended on March 31, many enrollees who could not pay higher premiums lost their coverage retroactively. About three in ten people with Marketplace plans in 2025 no longer had coverage in 2026. Some found alternative insurance through employers or public programs, while others switched to less comprehensive plans or became uninsured. This reversal of previous coverage gains highlights how policy changes and rising costs combined to push many Americans out of affordable health insurance.