As Congress continues to debate extending subsidies for the Affordable Care Act, states are seeing more people cancel their insurance. Multiple states reported drops in coverage, according to data from the Centers for Medicare and Medicaid Services.
Subsidies for health care plans expired at the end of last year for those using the ACA, sometimes referred to as Obamacare, after lawmakers couldn’t agree on extending the subsidies. This has caused insurance prices to dramatically rise for those on the plan, with nonprofit health group KFF stating the average estimated increase for subsidized enrollees was 114%.
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Lawmakers are working on a bipartisan deal to use a spending bill to change parts of the health care system, focusing on the middleman accused of increasing drug prices. However, that deal may be in jeopardy as Democrats refuse to vote on a spending bill that would fund Immigration and Customs Enforcement after agents killed Alex Pretti.
How many fewer people are enrolling in ACA insurance?
Only eight states and Washington, D.C. saw increases in the 2026 enrollment period compared to last year, CMS data shows. All of these states exceptTexas use state-based exchanges.
Total ACA enrollment dropped from 24.2 million enrollees in 2025 to 22.8 million in 2026, a nearly 6% reduction.
But industry insiders say this drop is only the beginning. They expect many more people to drop coverage as costs creep up this year.
To keep up with costs, many enrollees are choosing lower-coverage plans than they did last year. State Affairs reports that 73% of enrollees in California who switched plans moved to a bronze plan, the lowest level of coverage.
“A number of factors lead us to believe that this is just the tip of the iceberg,” Virginia’s Insurance Marketplace director Keven Patchett told State Affairs. “We’ve heard far too many consumer stories about the kinds of sacrifices and lifestyle changes that they’re having to make in order to afford their coverage.”
These lower-level plans offer the lowest monthly premiums but with deductibles as high as $10,000. These plans are often marketed to those who rarely require medical care.
What states are expanding their coverage?
To help combat the insurance price increases, some states have expanded ACA subsidies. CBS News reports 10 states now offer subsidies in addition to federal ACA tax credits.
Six states — California, Colorado, Connecticut, Maryland, Massachusetts and New Mexico — all increased their state-funded ACA subsidies for 2026 in anticipation of the cost increases.
KFF said that some states with state-based marketplaces saw more enrollments in 2026. Of the eight states that saw increases, seven had SBMs. Washington, D.C., which also has an SBM, saw an increase.
While state health care assistance isn’t as generous as federal aid, experts say it helps reduce the number of people dropping their insurance altogether.
“They soften the blow,” Louise Norris, a health policy analyst for healthinsurance.org, told CNBC.
