Enrollment in the Affordable Care Act (ACA) has fallen by over 1 million individuals following the expiration of enhanced tax credits that previously made health insurance more affordable. According to Cory Smith from The National News Desk, the number of people enrolled in ACA plans dropped significantly after the open enrollment period ended on January 15, 2026.
Impact of Expiring Subsidies
The decline in enrollment comes after the enhanced subsidies, introduced in the 2021 American Rescue Plan and extended through the 2022 Inflation Reduction Act, were allowed to lapse. These subsidies played a crucial role in keeping health insurance premiums manageable for many Americans. With their expiration, premiums are projected to rise sharply, potentially more than doubling for some.
For instance, the Kaiser Family Foundation indicated that an individual earning $35,000 annually could see their benchmark plan premiums surge from $1,033 to $2,615 per year — a staggering increase of nearly $1,600.
Experts, including ACA analyst Haeder, anticipate that the current decline in enrollment may only be the beginning. “There’s probably going to be a bunch more falling off over the next few months,” Haeder noted, underscoring concerns that many of those who retained their plans were hoping for an extension of the subsidies.
Long-Term Consequences for Health Coverage
Currently, approximately 19.5 million people remain enrolled in ACA plans, a decrease of about 4.6 million compared to last year. This drop has raised alarms about the potential for millions more to lose health coverage entirely as they face escalating premiums.
Haeder warns that many individuals may soon drop their coverage, particularly those who are generally healthy and may not see immediate medical needs. “People will find it hard to come up with the extra money to continue Obamacare coverage if they’re not really sick,” he stated. This trend could lead to a situation where only those with serious health issues maintain their plans.
This enrollment decline is likely to exert additional pressure on healthcare providers, especially in states that have not expanded Medicaid, such as Texas and Florida. Haeder pointed out, “We’re going to see some pressure on health care providers, particularly in rural areas,” as uninsured individuals may delay seeking treatment until faced with severe health crises.
As the financial burden of insurance becomes more pronounced, it is anticipated that many individuals will face difficult choices regarding their health coverage. “When the bigger bills start arriving, there’s probably going to be another wave of people dropping coverage,” Haeder added. Insurance carriers may also begin automatically terminating coverage for those who fail to pay their premiums for several months, potentially leading to a final wave of disenrollment around April.
The implications of this mass disenrollment are profound. As millions of Americans navigate the complexities of health insurance, the landscape of healthcare access in the United States may shift dramatically, raising critical questions about the future of the Affordable Care Act and the security of health coverage for vulnerable populations.
