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ACA enrollment drops by 1M-plus after subsidies expire

More than 1 million Americans left ACA coverage as pandemic-era premium tax credits expired, causing premiums to rise sharply and some states to expand their own subsidies.

  • For 2026, the Centers for Medicare & Medicaid Services reported ACA marketplace enrollment fell by over 1 million, to nearly 23 million, reversing the record-high 24 million enrollees from last year.
  • The enhanced COVID-era premium tax credits expired, ending the temporary boost to affordability after the House of Representatives recently approved an extension but the U.S. Senate failed to pass it.
  • KFF projected that without subsidies, premiums would more than double, and a person making $35,000 would see costs rise nearly $1,600, Abernathy said, `'Greater use of expensive prescription drugs such as GLP-1 drugs like Ozempic and Wegovy, and greater healthcare use across the board, as well as inflation.`
  • Covered California Executive Director Jessica Altman said California allocated $190 million to aid vulnerable residents, with 1,906,033 enrolled as of Jan. 17, while urging enrollment before the Jan. 31 deadline.
  • Experts warn insurers will start dropping coverage for nonpayment, risking a final wave of passive disenrollments around April that could leave millions more uninsured, straining providers.
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NW Arkansas Democrat Gazette broke the news in Arkansas, United States on Wednesday, January 28, 2026.
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