ACA Sign-ups Drop after Subsidies Lapse

July 28, 2026

The end of enhanced premium tax credits had a significant impact on coverage across Affordable Care Act (ACA) marketplaces.

A new analysis from the Kaiser Family Foundation (KFF) this week evaluated broader trends across the individual insurance market, which saw enrollment drop from 21.8 million to 19.2 million.

• Big picture:  Average premiums ($624) rose significantly this year, as did the consumer share of those premiums ($172)
• Largest dropoffs:  The states with the largest falloffs in effectuated enrollment were Ohio and Oklahoma (both 32%), and Arizona (30%).
• In Pennsylvania:  About 94,000 people have dropped coverage following the end of open enrollment, with enrollment currently at 431,270, per updated Pennie statistics.
• Noteworthy:  New Mexico is the only state to fully replace the loss of the enhanced premium subsidies, and its effectuated enrollment grew 14 percent from 2025 to 2026.
• Quotable:  “While effectuated enrollment data do not capture the reasons coverage lapsed, these significant declines in enrollment correspond with rising premium payments after the expiration of enhanced premium tax credits,” the KFF analysis notes.

Additional information is available online.