ACA Enrollment Drops by 2.6 Million After Subsidies Expire

Federal data released in late June reveals that approximately 2.6 million Americans dropped Affordable Care Act (ACA) health insurance plans in February 2026 compared to the previous year. This represents a 13% decline in total enrollment, falling from 22.1 million to 19.2 million. The U.S. Department of Health and Human Services attributes the decrease to a crackdown on fraudulent phantom enrollments.

Health analysts and state officials argue the primary driver was the January 1 expiration of enhanced premium tax credits, which caused monthly premiums to double or triple for many subsidized enrollees, with some increases averaging 114%. Florida experienced the largest raw loss of coverage with roughly 443,000 people dropping plans, while Ohio and Oklahoma saw the steepest proportional declines, both exceeding 32%.

New Mexico was the only state to see an increase in enrollment, gaining 14% after the state government approved legislation to use state funds to replace the expired federal subsidies through mid-2027. The decline was more pronounced in states relying on the federal marketplace than in those with state-based exchanges. Analysts from KFF suggest that tighter immigrant eligibility requirements also contributed to the losses.