ACA Enrollment Falls 1.2 Million After Tax Credits Expire, Marking Biggest Drop Since 2014
Updated
Updated · Newsweek · Jun 15
ACA Enrollment Falls 1.2 Million After Tax Credits Expire, Marking Biggest Drop Since 2014
3 articles · Updated · Newsweek · Jun 15
Summary
Marketplace sign-ups fell by 1.2 million people in the 2026 open enrollment period, a 5% decline from 2025 and the largest annual drop since ACA exchanges began in 2014.
Enhanced federal tax credits expired at the start of 2026 after the Trump administration let them lapse, pushing average premiums up an expected 75% and making coverage harder to afford.
41 states posted enrollment declines, with North Carolina down about 22%; New Mexico was the biggest gainer at 18%, and only a small group of states held steady or increased.
KFF found affordability strains already deepening: 9% of 2025 marketplace enrollees had become uninsured, 4% of returnees had not paid their first premium, and 17% doubted they could afford coverage all year.
Analysts warn the losses could widen well beyond this enrollment season, with the CBO previously projecting marketplace enrollment could shrink roughly 25% after the subsidies ended.
With millions losing health coverage, what is the secret behind the states where enrollment is actually growing?
As insurance costs surge, are cheaper, high-deductible plans a viable solution or a financial trap for families?
The 2026 ACA Enrollment Crisis: How Expiring Premium Tax Credits Are Fueling a Surge in Uninsured Americans
Overview
In 2026, ACA Marketplace enrollment dropped sharply, mainly because enhanced premium tax credits expired at the end of 2025. This policy change, along with other legislative adjustments, caused healthcare costs to rise for millions of Americans. As a result, many people found it harder to afford and keep their health coverage, leading to a smaller insurance marketplace and more consumers being underinsured. The loss of financial help directly impacted Americans’ ability to maintain coverage, highlighting how policy shifts can quickly affect both affordability and access to healthcare across the country.