Affordable Care Act enrollment shrank dramatically in many states over the past year, new federal data shows

July 6, 2026 - 22:49

New federal data shows that enrollment in Affordable Care Act plans dropped sharply across much of the country over the past year, with some states losing nearly a third of their participants. The figures provide the first complete state-by-state breakdown of the declines that followed the expiration of enhanced subsidies.

Ohio and Oklahoma each saw a drop of roughly one-third of their enrollees. Other states also experienced significant losses. The reductions were not spread evenly, however. Some states managed to hold steady or even see slight gains, but the overall trend was a clear contraction in the marketplace.

The enhanced subsidies, which were part of pandemic-era relief measures, had made plans more affordable for many Americans. When those subsidies expired, premiums rose for many consumers, leading to a wave of cancellations and non-renewals. The new data captures the full scope of that fallout for the first time, showing how deeply the change affected individual state markets.

Experts say the enrollment losses could leave hundreds of thousands of people without health coverage, especially in states that did not expand Medicaid. The data also highlights the uneven impact across the country, with some states' insurance markets more vulnerable to the subsidy expiration than others.