Obamacare Subsidies End.
Obamacare Coverage Sees 1.2 Million Drop After Enhanced Subsidies Expire, Data Shows.
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ACA marketplace coverage losses are shaping up to be far worse than early numbers suggested. Initial sign-ups for 2026 fell by 1.2 million — a 5% drop and the biggest decline since the marketplaces opened in 2014 — after Congress let enhanced subsidies expire on December 31, 2025, according to Families USA.
But that number may only be the beginning. Researchers warn that the real damage shows up after the first premium bill comes due — and state-level data is already flashing red.
Premium Bills Arrive and Enrollees Start Dropping
When subsidies expired, monthly premiums after assistance jumped from $113 in 2025 to $178 in 2026 — a 58% increase, according to KFF. For enrollees who stayed in the same plan without any subsidy, annual costs nearly doubled, from $888 to $1,904.
The pain showed up fast. About 14% of January 2026 enrollees did not pay their first premium — double the historical average, AJMC reported. In Arkansas alone, marketplace membership fell 16.2% between January and April 2026 as people simply walked away. Researchers Stacey Pogue and Sabrina Corlette of the Commonwealth Fund called the emerging data a "bleak picture," warning that effectuated enrollment — the people who actually pay and keep coverage — could fall by as many as 5 million by year-end.
How Congress Let the Subsidies Die
The enhanced premium tax credits were created by the American Rescue Plan in 2021 and extended in 2022. They did two key things: they removed the income cap that cut off help at 400% of the poverty level, and they lowered what every enrollee paid out of pocket. By 2025, they had pushed ACA enrollment to a record 24.3 million people, with 92% of enrollees receiving some form of assistance, according to FactCheck.org.
Congress did not renew them. A 43-day government shutdown in fall 2025 — partly a fight over the subsidies — ended with no extension. In January 2026, 17 House Republicans broke ranks and helped pass a three-year retroactive extension, 230-196. Senate Republicans blocked it. Speaker Mike Johnson called the subsidies "bad policy," and Senate Majority Leader John Thune said the House bill lacked "reforms to curb fraud or limit high-income recipients," PBS reported.
Middle-Income Families and Minorities Hit Hardest
The people hit hardest are middle-income enrollees just above the 400% poverty level — the group that lost the most when the subsidy cliff returned. In California, those consumers are canceling coverage at double the 2025 rate. Black consumers in California are also canceling at twice last year's pace, according to AJMC.
Across the country, enrollees are shifting toward cheaper, skimpier plans. Bronze plan enrollment jumped from 30% to 40%, while Silver plan enrollment — which covers more — fell from 56.2% to 42.6%, Families USA found. The average deductible also grew by more than $1,000 in 2026. Some states are fighting back: California set aside $190 million and New Mexico $17 million to partially replace lost federal credits, though both admit those funds won't last.
Health Care Costs Become a 2026 Election Flashpoint
The political fallout is mounting. A KFF Health Tracking Poll found two-thirds of the public believe Congress did the "wrong thing" by letting the subsidies expire. Health care costs have surpassed gas and groceries as the top financial worry for Americans heading into the midterms, according to KFF.
Anthony Wright of Families USA said "deliberate decisions by President Trump and Congress have driven millions more Americans to be uninsured or underinsured." Meanwhile, the Commonwealth Fund projects the loss of $31 billion in federal subsidy spending will shrink state GDPs by $40.7 billion and eliminate roughly 339,100 jobs. Six major insurers, including Cigna and CareSource, have already announced plans to exit ACA markets entirely in 2027.
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