About 2.6 million Americans who buy health insurance through Affordable Care Act (ACA) marketplaces dropped their coverage between February 2025 and February 2026, federal data released on June 26 shows. Enrollment fell from 21.8 million to 19.2 million, a 12% decline and the steepest single-year drop since the marketplaces opened in 2014, according to fortune.com.
The enrollment decline is primarily linked to the expiration of enhanced premium tax credits that had been in place from 2021 through 2025. These subsidies, enacted during the COVID-19 pandemic, lowered monthly payments and more than doubled marketplace enrollment between 2020 and 2024. When the subsidies lapsed at the end of 2025, the average cost for enrollees to keep the same plan jumped by about 114%, prompting many to drop coverage or switch to cheaper, higher-deductible plans, fortune.com reported.
The expiration of these subsidies has significant implications for health insurance affordability and access. The ACA marketplaces serve as regulated platforms for individuals and small businesses to purchase compliant private health insurance. The sharp enrollment decline highlights the impact of subsidy policies on coverage rates and raises concerns about the health outcomes for those who lose coverage due to cost increases, according to a health economist cited by fortune.com.
Federal data released on June 26, 2026, confirms the enrollment drop, marking a critical moment for policymakers considering the future of ACA subsidies and marketplace affordability.