About 3 Million Fewer People Held ACA Marketplace Plans in February Than a Year Earlier
About 3 million fewer people held Affordable Care Act marketplace health insurance plans in February 2026 than in February 2025, according to new federal enrollment data reported by The Associated Press. The decline followed the expiration of enhanced federal premium subsidies and rising costs for consumers.
The year-over-year change is an early indication of how affordability is reshaping access to coverage in the individual insurance market. It does not show that all 3 million people became uninsured. Some may have moved to employer coverage, Medicaid or other plans, while others may have left marketplace coverage because of administrative changes or changes in eligibility.
A sharp change after subsidies expired
Enhanced federal premium subsidies had helped reduce the cost of marketplace plans for many enrollees. After those subsidies expired, consumers faced higher 2026 premium costs, according to the AP report and an analysis from KFF cited in that coverage.
KFF said more than 20 million subsidized enrollees were affected by the higher 2026 premium costs. The resulting financial pressure came as people evaluated whether to keep their marketplace plans, select different coverage or leave the marketplace altogether.
Premium increases can affect people who buy insurance directly rather than through an employer, including consumers who do not qualify for job-based coverage. The available data show a major decline in marketplace enrollment, but they do not by themselves identify the individual circumstances of everyone who was no longer enrolled.
KFF projects a larger 2026 decline
The February comparison is smaller than the full-year decline KFF projected for 2026. Its analysis estimated that nationwide marketplace enrollment could fall by nearly 5 million people, a drop of more than 20% from the prior enrollment level.
That nearly 5 million figure is a projection, not a final count of people who lost coverage. The estimate also should not be treated as proof that every projected departure will result in a person becoming uninsured. Enrollment can change for several reasons, including affordability, administrative churn and eligibility changes.
The AP described the development as a national coverage and affordability issue. For consumers, the practical question is whether insurance remains affordable enough to keep, particularly after the additional federal assistance ended. For policymakers and insurers, the enrollment shift provides an early measure of how the individual market is responding to higher consumer costs.
Final federal data are still ahead
Final 2026 enrollment data from the Centers for Medicare and Medicaid Services were not public when the projection was reported. That means the February figure is preliminary relative to the final full-year CMS enrollment data.
CMS’s calendar for 2026 qualified-health-plan data submission and certification sets federal and state deadlines for rate review and filings. Under that schedule, July 31, 2026, is a key deadline for states with effective rate-review programs to post proposed rate increases subject to review.
Those postings will provide another point of information about the premium environment, but a proposed rate increase is not the same as a final approved rate. State and insurer filings would be needed to examine the reasons for particular premium changes; the available reporting does not establish that every increase resulted from one federal policy.
The next major benchmark is the release of final CMS enrollment information. Until that data are available, the February comparison and KFF’s nearly 5 million estimate should be read as indicators of a significant coverage shift, not as a final accounting of how many people became uninsured or how the entire 2026 marketplace will end.
Sources
- Millions drop Obamacare health coverage after subsidies expire and costs rise, Associated Press
- Affordable Care Act enrollment projected to plunge by 5 million as costs spike, Associated Press
- Key Dates for Calendar Year 2026 QHP Data Submission and Certification, Centers for Medicare and Medicaid Services
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