More than 3 million individuals who enrolled in Affordable Care Act (ACA) plans this year have dropped their coverage, primarily due to rising monthly premiums and the expiration of enhanced subsidies that previously made these health insurance options more affordable. As reported by the U.S. Department of Health and Human Services (HHS), enrollment figures have fallen sharply, from approximately 23.1 million in January 2026 to about 19.2 million by February of the same year. This decline follows a peak of around 24.2 million enrollees in January 2025.
The end of the enhanced ACA subsidies at the close of 2025 has led to average costs for insuring individuals skyrocketing by 114% in 2026, according to Kaiser Family Foundation (KFF), a health policy nonprofit. Experts highlighted that the lack of affordability is likely the main driver behind the significant drop in enrollment. “When you raise prices for a good or service, fewer people are going to buy it,” said Sabrina Corlette from Georgetown University’s Center on Health Insurance Reforms, emphasizing the direct correlation between cost and enrollment rates in health care.
The enrollment decline is further complicated by concerns regarding improper signups. The HHS report indicated that nearly half of the enrollment growth from 2021 to 2024 was believed to be due to improper, phantom, or fraudulent signups. The administration previously took steps to block those who were inaccurately receiving subsidies, with estimates suggesting that about 2.9 million people had been wrongly enrolled under the Trump administration.
While the HHS report raised concerns about potential fraudulent enrollments, including cases where enrollees signed up without a Social Security number, most analysts believe that the primary issue affecting enrollment is related to increased costs. This sentiment was echoed by Cynthia Cox of KFF, who stated that the drop in numbers was in line with expectations, given the recent changes in subsidy availability.
Cox also noted that there is a distinction between those who enroll in a plan and those who maintain their coverage by making monthly payments. As evidenced by the data, the number of individuals maintaining their insurance dropped from 22.1 million in 2025 to 19.2 million in February 2026.
Looking ahead, KFF researchers project that enrollment may continue to decrease as many consumers struggle with the heightened expenses of maintaining health insurance in addition to other rising costs for necessities like housing and groceries. A recent KFF survey indicated that 17% of those enrolled lacked confidence in their ability to afford premiums throughout 2026.
Moreover, a report from the Georgetown Center on Health Insurance Reforms highlighted that health insurers are likely to raise rates again for the upcoming year, projecting increases from 6.5% in Vermont to as much as 22.4% in Washington state for 2027 coverage. This forecast suggests that the affordability crisis will persist.
As the HHS faces ongoing scrutiny over fraudulent enrollment practices, it remains clear that the overwhelming concern for many individual consumers is the rising cost of health coverage. Corlette remarked on the troubling implications of the current trends: “The numbers are bad. It doesn’t look good when millions of people are unable to afford health insurance.” The fate of ACA enrollment hangs in the balance as both policymakers and consumers navigate these challenging economic conditions.
