ACA Enrollment Falls 16 Percent After Enhanced Subsidies End

Roughly four million Americans left Affordable Care Act plans this year after enhanced federal subsidies expired at the start of the year. Premiums rose by double digits for many enrollees, and the Centers for Medicare and Medicaid Services reported the decline in coverage late Friday.

The loss of the enhanced credits left an estimated 19.2 million people enrolled in ACA plans as of February. That figure is more than 16 percent below the 23 million who selected coverage during open enrollment, which itself was about one million lower than the prior year.

Congress did not extend the enhanced subsidies when they expired at the beginning of the year. Democrats had sought an extension during negotiations to reopen the government last year but accepted a later vote on a separate bill instead; that measure did not pass.

Administration officials said the enrollment drop reflects efforts to reduce fraud and improper enrollments. Insurers and policy analysts had warned that higher premiums would prompt some people to drop coverage or switch to lower-premium, high-deductible plans.

The report noted that current enrollment remains higher than any year before 2024. Officials said they do not expect a repeat of earlier periods when uncertainty and rising costs led some insurers to exit markets.