Millions Drop ACA Insurance Coverage after Open Enrollment

July 01, 2026

Over 3 million Americans, including nearly 80,000 Pennsylvanians, have dropped coverage on Affordable Care Act (ACA) marketplaces this year.

New state and federal data show significant reduction of enrollees on ACA marketplaces such as Pennie and healthcare.gov. Importantly, the data includes a look at effectuated coverage following the required grace period for most enrollees to catch up on late premium payments to start the year.

Here’s what you need to know:

• The big picture:  About 19.2 million Americans had coverage via the ACA marketplaces in February 2026, down from 22.1 million a year prior.
• Pennsylvania perspective:  As of June 1, 2026, total Pennie enrollment was 443,024. That’s down from the 2025 high of 497,000 enrollees.
  • About 75,000 residents have dropped coverage through the state marketplace Pennie since the end of open enrollment in January, officials said.
• Competing narratives:  State leaders highlighted increased costs following the end of ACA enhanced premium tax credits that helped lower the price tag for coverage. Federal officials counter that the lower enrollment is due to stronger enforcement against “large-scale improper, phantom, and fraudulent participation.”
• Threat on the horizon:  “Rising uninsured rates strain Pennsylvania’s healthcare system and economy. Higher uninsured populations are associated with increased medical debt, reduced workforce mobility and productivity, and higher levels of uncompensated care for hospitals and providers,” Pennie noted in a recent update.

Additional information from Pennie and the U.S. Department of Health and Human Services is available online.