Obamacare enrollment falls sharply as subsidies expire and costs rise
Updated
Updated · The New York Times · May 1
Obamacare enrollment falls sharply as subsidies expire and costs rise
11 articles · Updated · The New York Times · May 1
Insurers, state officials and analysts estimate marketplace coverage has dropped from 24 million last year to about 19 million, after initial sign-ups had already fallen by 1.2 million.
Wakely Consulting Group projects enrollment could decline by as much as 26% this year, while the federal government has not yet released current figures.
The pullback reverses recent Affordable Care Act gains as healthcare costs, premiums and out-of-pocket spending rise nationwide, and the issue is expected to feature in this year's midterm elections.
With millions priced out of health insurance, what new coverage models are states and innovators proposing for the future?
How is the surge of uninsured Americans affecting family finances, hospital stability, and the wider U.S. economy?
Faced with soaring premiums, are cheaper health plans a true safety net or a fast track to medical debt?
ACA Enrollment Plummets by 1.4 Million in 2026 After Federal Subsidy Expiration
Overview
In 2026, ACA marketplace enrollment dropped sharply by over 1 million due to the expiration of enhanced premium tax credits at the end of 2025. This caused premiums to rise significantly, especially for middle-income families facing the reinstated subsidy cliff at 400% of the Federal Poverty Level. Many consumers downgraded to high-deductible plans or dropped coverage, leading to increased financial strain and delayed medical care. States that funded their own subsidies, like New Mexico, saw enrollment gains, while others experienced steep declines. Political gridlock prevented subsidy extensions, fueling public blame and making healthcare costs a top issue in the 2026 midterm elections.