ACA Marketplace Enrollment Falls to 19.2 Million After Enhanced Subsidies Expire

About 3 million fewer people in the United States had Affordable Care Act health insurance plans in February compared with the same time last year, according to new federal data. Enrollment fell from 22.2 million in February 2026, the U.S. Department of Health and Human Services reported Friday.

The 13 percent decline occurred after federal subsidies expired on January 1. The subsidies ended under the Republican-backed One Big Beautiful Bill Act enacted in July 2025. Health analysts linked the enrollment drop to resulting premium increases that left many people unable to pay.

“We know that real people lost their health insurance coverage,” said Cynthia Cox, vice president and director of the ACA program at KFF. ” The data, compiled in April, reflect coverage status after the nonpayment grace period expired. A January federal estimate had already shown about 800,000 fewer sign-ups compared with January 2025.

Cox said KFF expects total ACA enrollment to fall further, potentially reaching 17.5 million by the end of 2026. The program serves working-age people without employer coverage, including gig workers, farmers and others.