2.6 Million Americans Lost ACA Coverage as Subsidies Expired

Federal data released on June 26, 2026, indicates a significant decline in Affordable Care Act (ACA) marketplace enrollment, with 2.6 million fewer Americans holding coverage in February 2026 compared to February 2025. This drop represents a 12% decrease, bringing the total enrollment down from 21.8 million to 19.2 million people. This marks the steepest single-year enrollment decrease since the marketplaces began operating in 2014.

The primary driver for this enrollment drop is the expiration of enhanced ACA premium tax credits, which had been in effect from 2021 through 2025. These subsidies, implemented during the COVID-19 pandemic, more than doubled marketplace enrollment between 2020 and 2024 by reducing monthly payments for enrollees. Upon their lapse at the end of 2025, the average cost for enrollees to maintain the same health insurance plan surged by approximately 114%.

Even with some individuals switching to plans with lower premiums but higher deductibles, the average premium payments for marketplace plans still increased by 58%. Furthermore, deductibles rose by an average of 37%, translating to over $1,000 per person. By February 2026, only 83% of individuals who had selected a marketplace plan had completed their premium payments, suggesting financial strain even for those who attempted to retain coverage.