Enrollment in Affordable Care Act (ACA) health insurance plans has dropped significantly in the United States. Federal data, released by the U.S. Department of Health and Human Services, shows a 13% decrease in enrollment from last year. The number of people covered by ACA plans fell from 22.1 million in 2025 to 19.2 million this year.

The decline may be linked to a federal effort to eliminate fraudulent enrollments. However, health analysts suggest the expiration of federal subsidies on January 1 played a more significant role. These subsidies had previously softened the cost of premiums, and their removal caused sharp increases in prices that many found unaffordable. Cynthia Cox, associated with healthcare research nonprofit KFF, highlighted the real impact on individuals. She emphasized survey results showing numerous people left their plans due to soaring costs, noting that coverage losses coincided with widespread premium hikes.

The data, first compiled in April, reflects the situation as of February, capturing the effects after a grace period for unpaid bills lapsed. Earlier federal estimates indicated a drop of about 800,000 fewer sign-ups compared to the same period last year. This marked the first decline in ACA enrollment within the past four years during the designated shopping window.

KFF predicts a continued downward trend in ACA participation, potentially reducing to 17.5 million participants by year-end. Such a reduction would impact the government’s primary subsidized health insurance plan for working-age individuals not eligible for Medicaid.

ACA plans have been pivotal for those without traditional employer coverage, including gig workers, farmers, and hairstylists. The expiration of ACA subsidies was contested in Congress last fall, with bipartisan calls for renewal. Rising healthcare costs have heightened concerns among voters, particularly with upcoming elections where affordability stands as a key issue.