About 3 million fewer Americans had Affordable Care Act (ACA) health insurance plans in February compared with the same time last year, according to new federal data released by the U.S. Department of Health and Human Services. Enrollment dropped 13% from 22.1 million in 2025 to 19.2 million in 2026, reflecting the first official government data showing the impact of subsidy expiration on ACA coverage.
The report, published Friday, suggests the decline could be partly due to a federal crackdown on fraudulent or “phantom” enrollments. However, health analysts attribute the drop primarily to the expiration of federal subsidies on January 1, which caused premium costs to surge. Cynthia Cox, vice president and director of the ACA program at the healthcare research nonprofit KFF, noted that many people lost coverage as they faced double- or triple-digit premium increases and could not afford payments.
This enrollment decline marks a reversal after years of growth in ACA plan sign-ups. The data, compiled in April but reflecting coverage in February, captures the marketplace after the expiration of a nonpayment grace period. A January federal estimate had already indicated about 800,000 fewer sign-ups compared with the previous year, highlighting the financial strain on consumers following subsidy cuts.
The new figures provide the government’s first comprehensive look at how premium affordability affected total ACA enrollment this year, underscoring the challenges faced by millions of Americans in maintaining health insurance coverage amid rising costs.