Drop in ACA Health Insurance Enrollment Amid Rising Costs

New York (AP) — Approximately 3 million fewer individuals in the U.S. had Affordable Care Act (ACA) health insurance plans as of February than at the same time last year, according to recent federal data. This report from the U.S. Department of Health and Human Services revealed a 13% decrease in enrollment, from 22.1 million in 2025 to 19.2 million in the current year.

The department attributed the decline to increased efforts to address fraudulent or ‘phantom’ enrollments. However, experts in the health field suggest the expiration of federal subsidies on January 1 is more likely responsible for the reduction. This expiration led to a spike in plan costs, making it difficult for many to afford their premiums.

‘We know that real people lost their health insurance coverage,’ stated Cynthia Cox, a vice president at the healthcare research nonprofit KFF, highlighting survey data on individuals who exited their plans. ‘This coverage loss occurred simultaneously with significant increases in premium payments.’

The fresh figures, compiled in April, offer the government’s first detailed examination of how missed first payments affected overall enrollment this year. The numbers reflect the state of the marketplace once a grace period for nonpayment concluded.

In January, a federal estimate indicated that about 800,000 fewer people signed up for ACA plans compared to the previous year, marking the initial decline in the last four years during the enrollment period. Cox noted that KFF anticipates the number of enrollees in the government healthcare scheme might continue to fall, potentially reaching around 17.5 million throughout the year.

This would represent a significant reduction for the flagship subsidized insurance program aimed at working-age individuals not eligible for Medicaid. In recent times, ACA plans have emerged as a favored option for gig economy workers, farmers, ranchers, hairstylists, and others lacking employer-provided health coverage.

The termination of ACA subsidies was the subject of intense debate in Congress last fall, with advocacy from both Democrats and some Republicans for their renewal. As voters prepare for the November elections, affordability in health insurance is highlighted as one of the major concerns.