State Data Show 1.2 Million Drop in 2026 ACA Sign-Ups After Expiration of Enhanced Subsidies

Newly released monthly enrollment data through April 2026 from Arkansas, Colorado, Maryland, Massachusetts, New Mexico and New York show that a significant number of people canceled coverage or did not pay premiums after signing up during the 2026 open enrollment period, according to an analysis by Georgetown University researchers.

2 million, a 5 percent drop from the prior year and the largest annual decline since the marketplaces opened in 2014. Federal officials have so far released only initial sign-up totals, which include people whose coverage was automatically renewed at the end of 2025.

Researchers Stacey Pogue and Sabrina Corlette said post-bill data are needed to measure actual retention. Initial data from several state exchanges showed plan cancellations up 24 percent compared with March 2025. In states reporting demographics, middle-income consumers who lost enhanced premium tax credits accounted for most cancellations.

Maryland recorded a 13 percent enrollment drop between January and April 2026, compared with 3 percent in the same period in 2025. Arkansas posted a 16 percent decline, double the 2025 figure. 5 percent in 2025.

The lowest-income enrollees were the only group less likely to drop coverage than last year because state-funded subsidies shielded them from rate increases. ” Analysts anticipate overall 2026 marketplace enrollment falling by about 5 million people, with additional losses expected in 2027 from policies in the One Big Beautiful Bill Act and potential regulatory changes.