ACA enrollment fell sharply after enhanced subsidies expired
Federal data highlighted on July 6 show Affordable Care Act marketplace enrollment fell dramatically over the past year, with roughly 2.6 million fewer people holding ACA plans in February 2026 than a year earlier. Analysts said it was the first state-level accounting of how far enrollment dropped after enhanced federal premium subsidies expired on January 1.
The declines were steepest in states that use the federal Healthcare.gov marketplace. Ohio and Oklahoma each lost more than 32% of their enrollees, and Arizona, South Carolina, Minnesota, Indiana, Michigan, Mississippi, Louisiana, and Missouri each shed more than a quarter. Florida recorded the largest raw drop, about 443,000 people, while remaining the biggest marketplace with nearly 4 million enrollees.
New Mexico was the only state to gain enrollment, up about 14%, after it used state funds to fully replace the lost federal subsidies — a pattern that underscores how directly the subsidy lapse, rather than falling demand, drove the coverage losses. Without a renewal of the enhanced credits, premiums rise for many remaining enrollees, which tends to push additional healthier customers out of the pool.