Enrollment in Affordable Care Act health plans fell by nearly 3 million people as federal COVID-era subsidies expired [1].
This decline represents a significant shift in healthcare access for millions of low- and middle-income Americans who relied on government assistance to afford monthly premiums. The loss of these subsidies has created a financial barrier to coverage, leaving a larger portion of the population uninsured.
Data released for February 2026 shows that about 3 million fewer people held ACA plans compared with February 2025 [3]. This downturn follows a jump in premiums at the start of 2026 after Congress let the pandemic-era tax credits lapse [1].
The impact is visible across the country, with specific declines noted in several states. In Texas, ACA enrollment dropped 4% following the expiration of the tax credits [2].
The subsidies were designed to lower out-of-pocket costs during the public health emergency. Without the federal support, the cost of maintaining a plan became prohibitive for many consumers, leading them to drop their coverage entirely [1].
While the exact dollar amount of the premium increases was not specified in the data, the correlation between the expiration of the subsidies and the drop in enrollment is clear [1]. The loss of coverage affects both national totals and state-level participation in the health insurance marketplace [2].
“Enrollment in Affordable Care Act health plans fell by nearly 3 million people”
The expiration of COVID-era subsidies highlights the volatility of healthcare affordability when tied to temporary legislative measures. Because millions of residents have now lost coverage, there may be an increased burden on emergency rooms and public health clinics to provide care for the newly uninsured population.
