These findings echo data recently released by CMS, which show that people are paying much more for ACA marketplace coverage even while shifting into less generous plans, per @nicolerapfogel.bsky.social www.cbpp.org/blog/new-dat...
But coverage loss isn’t the full story. People are paying more for less. Among those who stayed covered, many switched to less generous plans with higher deductibles. And people who kept coverage are more likely to have higher health risks, which could increase premiums for everyone in the future.
Of note, approximately 14% of people who chose an individual market plan starting in Jan 2026 didn’t pay their first premium. But this drop-off was muted in state-based marketplaces, many of which provided subsidies to make up for the loss of PTC enhancements or adopted other affordability measures.
Following the expiration of PTC enhancements, #ACA marketplace plan selections dropped by 1.2 million during the 2026 open enrollment period. A new analysis suggests that millions more will drop coverage over the year as enrollees confront higher monthly premiums. www.wakely.com/blog/who-pai...
Today marks the 16th anniversary of the #ACA. The law covers record numbers of people in #Medicaid and the marketplaces, bans insurer discrimination against people with health conditions, and helps millions afford their health costs. Unfortunately this is all now at risk.
New data show a fuller picture of how Congress's decision to let PTC enhancements expire impacted people. It's not just coverage loss, people are downgrading to less comprehensive coverage and cutting back on other basic needs.
Bar chart showing distribution of enrollees by age in the ACA Marketplace for 2023. Ages range from 0 to 64, with the highest number of enrollees in the 50-64 age group, highlighted in green. Enrollee numbers are on the vertical axis, peaking around 600K. Chart is sourced from KFF analysis via Health System Tracker.
Adults 50-64 are disproportionately affected by the expiration of ACA enhanced premium tax credits, as they make up a large number of Marketplace enrollees & premiums rise with age.
Our analysis shows older enrollees with moderate to higher incomes have been hit hardest: https://on.kff.org/4l0zwfY
My latest: New A.C.A. Plans Could Increase Family Deductibles to $31,000 www.nytimes.com/2026/02/26/h...
President Trump didn't mention at all in his SOTU the most significant changes to health care he and Republicans in Congress have engineered: the biggest Medicaid cuts ever, expiration of enhanced ACA premium subsidies, and scaling back recommended vaccines.
This is just the beginning - more people are expected to drop coverage or face financial hardship as premium payments stack up throughout the year. And those who switched to lower-premium plans with higher deductibles may face sticker shock when they need care.
On the heels of expired PTC enhancements that resulted in 1 million—and counting—fewer people enrolling in #ACA marketplace plans for 2026, CMS released a proposed rule for 2027 that would reduce marketplace enrollment by 2 million people in 2027 alone. @claireheyison.bsky.social explains:
#ACA marketplace plan selections are down by more than a million people as of late January, but coverage losses will almost certainly be higher. And the harm stemming from Congressional Republicans' failure to extend PTC enhancements goes much deeper than coverage loss. More in my blog post below.
The impacts of letting PTC enhancements expire go beyond coverage loss - higher premiums have led many to purchase less generous coverage, as @statesnewsroom.com reports.
www.newsfromthestates.com/article/aca-...
New KFF poll results: Health care is a top affordability worry, and two-thirds of those surveyed say Congress did the wrong thing not extending the ACA marketplace premium tax credit enhancements. www.kff.org/public-opini...
Powerful words at #HAC2026 !
In @nytopinion.nytimes.com
Tapping retirement savings. Researching a move to a different country. Dropping health insurance altogether. These are the stories of Americans who are struggling to pay rising health care premiums after Obamacare subsidies expired.