New federal data reveals that around 3 million fewer people were enrolled in Affordable Care Act (ACA) health insurance plans in February compared to the previous year. The U.S. Department of Health and Human Services, in a report released Friday, noted a 13% drop in enrollment, from 22.1 million people in 2025 to 19.2 million this year.
Officials attributed this decrease to efforts to combat fraudulent enrollments. However, health analysts argue the expiration of federal subsidies on January 1 had a more significant impact, leading to increased plan costs and making premiums unaffordable for many. Cynthia Cox, a vice president and director of the ACA program at KFF, highlighted how the loss of coverage coincided with soaring premium rates, which surged by double or triple digits for some.
The data, collected in April and reflecting February coverage, provides an initial official look at how unpaid bills affected overall enrollment. This assessment came after the end of a grace period for nonpayment. In January, federal estimates showed approximately 800,000 fewer people signed up for ACA plans compared to the same time last year. This marked the first drop in enrollment during the initial sign-up window in four years.
Cox mentioned that KFF anticipates the decline in enrollment might continue throughout the year, possibly reducing the total number to about 17.5 million. This would represent a significant reduction for the government’s main subsidized insurance option for those unable to qualify for Medicaid.
ACA plans have gained popularity among individuals without employer-provided insurance, such as gig workers, farmers, ranchers, and hairstylists. The debate over renewing ACA subsidies was a contentious issue in Congress last fall, with support from both Democrats and some Republicans. As the November elections approach, voters express concerns about the affordability of health costs, spotlighted by the sharp increases seen in ACA and other health insurance programs.
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