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

By — Ali Swenson, Associated Press Ali Swenson, Associated Press Leave your feedback Share Copy URL https://www.pbs.org/newshour/health/affordable-care-act-enrollment-shrank-dramatically-in-many-states-over-the-past-year-new-federal-data-shows Email Facebook Twitter LinkedIn Pinterest Tumblr Share on Facebook Share on Twitter Affordable Care Act enrollment shrank dramatically in many states over the past year, new federal data shows Health Jul 6, 2026 3:51 PM EDT NEW YORK (AP) — States across the country saw steep drops in the number of people covered by the Affordable Care Act over the past year, with Ohio and Oklahoma each losing nearly one-third of enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the January expiration of enhanced subsidies. The data, posted in late June by the Trump administration and first reported on by The Associated Press, reveals how changes in each state's insured population led to around 2.6 million fewer Americans having Obamacare plans in February compared with the same time last year. Educate your inbox Subscribe to Here’s the Deal, our politics newsletter for analysis you won’t find anywhere else. It captures not only how many people signed up for or were automatically reenrolled in plans in 2026, but how many paid their first monthly premiums to keep coverage, according to Cynthia Cox, a vice president and director of the ACA program at the healthcare research nonprofit KFF, who reviewed the dataset. She said it accounts for people who were retroactively removed from coverage after a nonpayment grace period ended. "This is the first time we've seen state-level data that shows how much ACA marketplace enrollment truly fell," Cox said. "It's in line with our expectations, but it does show a very steep drop in the number of people with ACA coverage." Healthcare affordability is a central issue to voters Health analysts have kept a close eye on changes in ACA enrollment since the expiration of so-called enhanced premium tax credits caused many Americans' monthly health insurance fees to double or triple, forcing some to forgo coverage entirely. The subsidies had been at the center of a bitter fight in Congress last fall, with Democrats and some Republicans calling for their renewal. Health insurance costs have been rising across ACA and other health insurance programs at a time when voters in the approaching November elections say affordability is among their top concerns. In a report released last week, the U.S. Department of Health and Human Services suggested the significant drop in enrollment this year could be attributed to a federal crackdown on fraudulent or "phantom" enrollment. But analysts have said it was more likely related to the Jan. 1 expiration of federal subsidies, and other changes, including tightened requirements on which immigrants could access subsidized plans. Ohio, Oklahoma and Arizona saw the most significant dr