Millions drop Affordable Care Act coverage after subsidies expired

June 28, 2026 - 11:12

New federal data reveals a sharp decline in Affordable Care Act enrollment, with roughly 3 million fewer people holding ACA health insurance plans this February compared to the same month last year. The drop comes after temporary subsidies, which were expanded during the pandemic, expired at the end of 2024.

The figures, released by the Centers for Medicare and Medicaid Services, show total enrollment fell from about 21 million to 18 million. Experts say the loss of enhanced premium tax credits made plans unaffordable for many middle-income households. Without the subsidies, some families saw their monthly premiums jump by hundreds of dollars.

The expiration hit states that run their own insurance marketplaces particularly hard. In California, enrollment dropped by nearly 600,000. Texas and Florida also saw significant losses. Insurance brokers report that many former enrollees simply could not justify the cost, especially when faced with high deductibles.

Consumer advocates warn that the decline could lead to worse health outcomes. People without insurance often delay needed care, skip medications, or face financial ruin from unexpected medical bills. Some states have tried to fill the gap with their own funding, but most have not.

The Biden administration had pushed to make the enhanced subsidies permanent, but Congress did not act. With the current political climate, a renewal seems unlikely. For now, millions of Americans are left to navigate a patchwork of options, including short-term plans that offer fewer protections.

The data underscores a stark reality: when the cost of coverage goes up, many people simply walk away.