Key facts
- New federal data indicates a significant decrease in Affordable Care Act (ACA) enrollment nationwide over the past year.
- Ohio and Oklahoma experienced the steepest declines, losing nearly one-third of their enrollees.
- Overall, approximately 2.6 million fewer Americans held ACA plans in February compared to the prior year.
- The drop is largely attributed to the expiration of enhanced federal subsidies, which significantly increased monthly insurance costs for many.
- Florida recorded the largest absolute number of enrollees dropping coverage, with around 443,000 individuals.
- New Mexico was the sole state to report an enrollment increase, bolstering its program with state funds.
States across the U.S. have experienced substantial decreases in Affordable Care Act (ACA) enrollment over the past year, with Ohio and Oklahoma each losing nearly a third of their covered individuals. This trend, detailed in new federal data, reflects a nationwide drop of approximately 2.6 million fewer Americans holding Obamacare plans in February compared to the same period last year.
Analysts attribute the sharp decline primarily to the expiration of enhanced federal subsidies in January, which led to significant increases in monthly health insurance premiums for many consumers. These subsidies had been crucial in making coverage affordable, and their removal has forced some individuals to forgo insurance entirely. Florida, despite having the largest number of marketplace enrollees, saw the highest absolute number of people drop coverage, losing around 443,000 individuals.
The data, released by the Trump administration, provides the first comprehensive state-by-state breakdown of these enrollment changes. While the U.S. Department of Health and Human Services suggested a federal crackdown on fraudulent enrollment might be a factor, experts largely point to the increased cost of insurance and tightened eligibility for certain immigrant populations as the main drivers.
States that had previously seen significant enrollment gains due to the COVID-19 pandemic-era enhanced subsidies experienced some of the largest drops, indicating that many individuals had enrolled primarily because of the affordability boost. Conversely, New Mexico was the only state to record an enrollment increase, having used state funds to replace the lost federal subsidies. Federal marketplace states generally saw larger enrollment losses than those with state-based exchanges, many of which implemented measures to cushion the impact of expiring subsidies.