06.26.2026 / Statement

Nearly 4 Million Americans Dropped ACA Marketplace Coverage This Year

Drastic Drop Reveals Real Consequences of Trump Administration and Congressional Leaders’ Decisions to End Enhanced Tax Credits

WASHINGTON, D.C. – The Department of Health and Human Services (HHS) today released the effectuated data for 2026 enrollment in the Affordable Care Act marketplace which show only 19.2 million remain enrolled in coverage, a dramatic decrease of nearly 4 million from the 23.1 million who were enrolled in coverage in January. Since the start of the Trump Administration in January 2025, more than 5 million fewer people are enrolled in marketplace coverage. In response, Families USA Executive Director Anthony Wright issued the following response:

“This dramatic decrease of millions of Americans losing health insurance is the result of deliberate decisions by the President and Congressional leaders — it is what we feared but expected, given the end of the enhanced tax credit and other policies that make it harder to get on and stay on coverage.

“After historic enrollment highs just two years ago driven by the affordability assistance of the tax credits, this coverage collapse was a choice that Congress made. As a result, millions more will end up uninsured, living sicker, dying younger, and being one emergency away from financial ruin.

“The Administration’s efforts to explain away millions of Americans losing coverage with far-fetched claims of fraud and phantom enrollees is an insult to every person became uninsured or underinsured. The math is simple: Congress made health coverage more expensive, and millions of real people can no longer afford it.

“These results are real for the millions who faced premiums doubling, paying hundreds of thousands of dollars for coverage. The resulting price spikes and coverage losses are real for all who buy coverage as individuals, including gig workers, small business owners, young adults, seniors not quite of Medicare age, and many others. Bipartisan majorities in both house of Congress voted to extend the enhanced subsidies, but the Republican leaders and the President blocked every effort. The consequences are now undeniable: millions dropped from the rolls, and yet another year of double-digit premium increases.

“The resulting enrollment reductions are real, alongside millions more who will lose Medicaid coverage under this Administration. This new data was ironically released just before the one-year anniversary of the big budget bill being signed into law, making the largest cuts to Medicaid in history. This data shows the anniversary of H.R. 1 should not be a day of celebration, but of mourning.”

A deeper analysis of the enrollment data will be forthcoming.