Obamacare enrollment dropped sharply across the U.S. last year

New government data shows that about 2.6 million fewer Americans had health insurance through the Affordable Care Act in February 2026 compared to a year before. The drop happened after special government discounts — called enhanced subsidies — expired on January 1. Without those discounts, monthly insurance costs doubled or even tripled for many people. This was the first time detailed data showed exactly how enrollment changed in all 50 states.

Ohio and Oklahoma were hit the hardest, each losing more than 32% of their ACA enrollees over the past year. That means roughly one out of every three people who had a plan lost it. Arizona, South Carolina, Minnesota, Indiana, Michigan, Mississippi, Louisiana, and Missouri also saw big drops, each losing more than one-fourth of their covered populations. Florida had the largest total number of people leave — around 443,000 — though it still has nearly 4 million residents on ACA plans.

Health experts have been watching these changes closely. Cynthia Cox, a director at the health research group KFF, reviewed the new data and said it matched what analysts expected, but was still alarming. She explained that most people who left the ACA marketplace are probably going without any insurance at all. That is because the ACA marketplace is usually a place people turn to when they have no other option for coverage.

The federal government gave a different reason for the drop. The U.S. Department of Health and Human Services suggested the decline was linked to a crackdown on fake enrollments. However, most health analysts said the main cause was the end of the enhanced subsidies, along with new rules that made it harder for some immigrants to get discounted plans.

There was one bright spot in the data. New Mexico was the only state where enrollment actually went up — by about 14%. That happened because New Mexico's state government voted to replace the lost federal subsidies using its own money. The governor later signed a law to extend that help through mid-2027.

The data also showed that states using the federal website HealthCare.gov lost bigger shares of enrollees than states running their own insurance marketplaces. Many states with their own systems took steps to help residents afford coverage after the federal subsidies ran out. Health care costs are now a top concern for many voters heading into the November elections. The fight over these subsidies is likely to continue in Congress.