In 49 states, the number of people enrolled in Obamacare plans has declined since Congress made coverage more expensive by allowing federal subsidies to expire at the end of last year.
The lone exception was New Mexico, the only state that has used its own money to fully replace the expired aid, according to a new analysis by KFF, a health policy research group. [Florida saw a 10% decline in enrollment, from approximately 4.3 million in 2025 to 3.8 million in 2026. The state does not offer premium assistance.]
Late last month, the Trump administration announced that overall participation in the health insurance marketplaces created under Obamacare, officially called the Affordable Care Act, had declined by nearly 3 million people, to about 19.2 million from 21.8 million in 2025. That 2025 figure, the highest ever recorded, was the culmination of six years of steady increases.
In announcing the figures, the Trump administration blamed much of the growth since 2021 — the year former President Joe Biden took office — on “improper, phantom and fraudulent enrollment.” It said the number of people in those categories peaked at 5.6 million last year, and that this year’s decline was the result of its efforts to eliminate enrollees who misstated their income to gain access to free plans.
But KFF connected this year’s decline to the expiration of the enhanced federal subsidies. Designed as a temporary pandemic-era measure, the subsidies were made available by the American Rescue Plan Act in 2021 and later extended through the end of 2025 by the Inflation Reduction Act.
The enhanced subsidies were available to everyone, regardless of income. Additional federal aid provided to some of the lowest-income households entirely eliminated premium payments for some people. Congressional leaders let the subsidies expire on Dec. 31.
Under the Affordable Care Act, each state can either use the federal government’s online insurance marketplace, HealthCare.gov, or operate its own state-run exchange. In states with their own exchanges, including some that used their own money to partially replace the expired federal subsidies, the average enrollment drop was 6%, according to KFF. In states using the federal marketplace, the average decline was 15%.
Enrollment fell the most in Ohio and Oklahoma (32%), Arizona (30%), South Carolina (29%), Indiana (28%), Michigan and Minnesota (27%), and Louisiana and Mississippi (26%).
Enrollment in Connecticut, the District of Columbia, Idaho, Illinois, Massachusetts, Pennsylvania and Texas was flat or fell by less than 5%. In New Mexico, enrollment grew by 14%.
Justin Lo, a KFF senior researcher who co-authored the report, said in an email that the number of fraudulent enrollees in Obamacare is likely in the “hundreds of thousands,” rather than the millions. Higher estimates, he said, are based on “suspicious patterns that could be explained by fraud or by legitimate factors, the most notable of which is greater subsidies making coverage more affordable.”
“We had a huge growth in the marketplace uptake because a lot of people were seeing that they could now qualify for very cheap plans,” Lo said. “So now, when we’re looking at the loss…it’s people who had marketplace coverage now having to evaluate whether they want to continue it.”
The KFF report examined not just the number of people who enrolled in Obamacare plans this year compared with last year, but also how many maintained that coverage as the year went on. Many people, the group noted, enroll but then end up dropping coverage when they can’t make the first premium payment.
This year, Mississippi had the lowest rate of enrollees maintaining coverage past January, at around 61%, while South Carolina, Louisiana, Indiana and Oklahoma also had rates below 70%. In New Mexico, California, Nevada, Vermont, and Idaho — all states with their own marketplaces — at least 95% of enrollees kept their coverage.
Lo said it’s hard to predict how enrollment figures may look in a year, as some insurers that currently offer plans on the marketplaces “are reassessing their positions and their commitment” to participating.
“So, if insurers are pulling out, people who are seeking marketplace coverage might have fewer choices,” Lo said.
Obamacare insurers are proposing a median premium increase of 14% for 2027, which would be a double-digit hike for the second year in a row, according to a new analysis of preliminary rate filings. Rates should be finalized later this summer.
— Shalina Chatlani, Stateline
JimboXYZ says
Inflation Reduction Act, nothing more than another of the Biden-Harris extortion payment to the healthcare industry. Inflation was lower under Trump-Vance than it was under Biden-Harris. Not that inflation is acceptable for either. Yet ABF (Another Biden Failure) in all it’s glory. Maybe if we finally get people off alcohol & illegal drugs, the healthcare system will have to come around to finally providing healthcare for what the masses can really afford based upon what they actually pay them for incomes ? In the meantime, why should a healthcare premium be $ 1K per month for perfectly healthy citizens ? Anyone keeping track of everything Biden did from 2021-2024 that has failed to reduce inflation, like they seem to want to do for Trump ? Open borders, open funding sources, the USA is rampant fraud & abuse at every Federal program. The Healthcare industry is hiding behind Capitalism for profits. Would anyone go so far as to say the United Healthcare CEO is dead for that unaffordable price gouging ?
The dude says
At least now that rampant fraud and abuse is centralized to the oval office now…
Andrew Squigmond says
Doesnt make sense…
[Florida saw a 10% decline in enrollment, from approximately 4.3 million in 2025 to 8.3 million in 2026. The state does not offer premium assistance.]
FlaglerLive says
Thank you for pointing out the error, which was corrected. There was a dyslexic transposition of numbers: Florida saw a 10% decline in enrollment, from approximately 4.3 million in 2025 to 3.8 million in 2026.
Laurel says
So, how’s that “repeal and replace” and “concept of a plan” working for you? Promises kept?
What’s going on in the Land of Oz?
Trump said he wouldn’t touch Medicare, but…
https://www.newsweek.com/trump-medicare-part-d-subsidy-seniors-12258739
…when does he tell the truth?
Edith Campins says
Still waiting for trump’s healthcare plan…Cuts to SNAP, cuts to Medicare Part D, cuts to Obama Care but plenty of money for ballrooms, arches, and the Epstein War.
Edith Campins says
Still waiting for trump’s healthcare plan…Cuts to SNAP, cuts to Medicare Part D, cuts to food stamps, cuts to Obama care, cuts to medical research programs but plenty of money for ballrooms, arches, cage fights, tacky gold decorations at the WH, the no bid reflecting pool mess, the Epstein war, and the continuing witch hunts for anyone who dares disagree with the dictator in chief.
Larry says
2027 will see more people drop from Obamacare due to shortened enrollment period starting this fall AND because auto re-enroll is removed starting with this fall’s enrollment.
Before, if your plan didn’t change then you didn’t have to modify your enrollment in the fall if you wanted to stay on the same plan, similar to how it’s done with work related health insurance. New Obamacare rules will drop everyone from their plan each fall and 100% of enrollees must re-enroll each fall, else their coverage is cancelled.
Waste not want not says
The government can not afford to keep subsidize anything anymore
When will the people wake up and stop all the handouts that are provided currently?
Obamacare,while a start to the problem didn’t solve anything for the working class.
Would have thought Biden could have tweaked it a little make improvements?
The problem was do massive nobody could fix everything the first try.
BUT sleepy Joe didn’t help move it along at all
STOP ALL HANDOUTS
R.S. says
Right you are. No handouts. The Trump Administration needs weapons to kill people; we cannot afford to subsidize healthcare. If you want healthcare, you can always emigrate to a civilized country: Canada or in ’27 Mexico. “Love your neighbor like yourself” is a socialist plot to turn us all into raging communists! You got it, Mr./Ms. WNWN.
Al says
They want Healthcare as long as it’s free or almost free. Instead of Healthcare they received Health insurance, not quite the same. Now retired people on Medicare have to pay 206 a month after paying into Medicare their whole life. The whining class needs it free or they’ll hold their breath and jump up and down.
R.S. says
They want bombs in Israel as long as they’re free; they want healthcare in Israel as long as the US pays for it; they want VA benefits for their butchers in the IDF as long as these benefits come from the US; and Trump wants weapons to fight a pointless war without strategy. You’re with them–THAT whining class, right, Al? Wouldn’t do at all to support something for your own folks back home, huh?
Deborah Coffey says
Right, R.S. And, they call us “anti-American” and “unpatriotic.”