Doubled Premiums After Tax Credit Expiration

ACA marketplace enrollment has dropped significantly, falling by 1.4 million in 2026. This sharp decline follows the expiration of COVID-era enhanced premium tax credits, a major policy shift under the Trump administration that prioritized fiscal responsibility over expansive government subsidies. The move exposes the unsustainable nature of the previously inflated enrollment figures, forcing low- and middle-income families to confront dramatically higher premiums. While the administration credits the drop to removing waste and fraud, officials predict further disenrollment as households face the true cost of coverage without federal enhancements.

Story Snapshot

CMS reports 22.8 million total enrollees, down 1.4 million from 2025 amid expired enhanced tax credits.
Florida leads declines with over 260,000 fewer enrollees; Southern states hit hardest.
The Trump administration credits the drop to removing waste, fraud, and improperly enrolled individuals.
California bucks trend with state subsidies, highlighting federal overreach pitfalls.
Officials predict further drops as families face doubled premiums without endless handouts.

Enrollment Decline Signals End of ACA Bloat

Centers for Medicare & Medicaid Services recorded 22.8 million plan selections for 2026 ACA marketplaces as of early January. This figure marks a 1.4 million drop from January 2025 levels. The decline followed the expiration of COVID-era enhanced premium tax credits in December 2025. These subsidies had artificially inflated enrollment from 11 million in 2015 to over 24 million by 2025. President Trump’s policy shift ended the fiscal drain, prioritizing taxpayer protection over government dependency. Low- and middle-income families now confront real costs, rejecting the Obamacare illusion of free coverage.

I believe health care is a basic human right, yet Congress is denying Americans access by choosing not to extend ACA tax credits to make coverage affordable. The result? 1.4 million fewer people enrolled in ACA coverage this year. That's 1.4 million American lives more at risk.

— Andy Beshear (@AndyBeshearKY) January 15, 2026

Trump Administration Cuts Waste and Fraud

White House Spokesperson Kush Desai explained the drop as result of commonsense measures targeting waste, fraud, and abuse. The administration removed individuals improperly enrolled in highly subsidized plans. This approach aligns with conservative principles of limited government and fiscal responsibility. Policy officials like Matthew Buettgens of The Urban Institute noted consumers signed up amid uncertainty, then dropped out upon seeing true premiums. KFF estimates indicate out-of-pocket costs could more than double without enhancements. Such transparency empowers Americans to make informed choices free from federal crutches.

Trump’s reforms contrast sharply with Biden’s overspending that burdened working families. By curbing ineligible enrollments, the administration safeguards resources for legitimate needs. This victory underscores the failure of expansive entitlements that erode self-reliance and family values.

State Disparities Reveal Policy Realities

Florida saw the largest absolute decline, exceeding 260,000 fewer enrollees. Ohio, North Carolina, and Georgia also posted significant drops, particularly in Southern and Southeastern states. Healthcare.gov states reported 15.6 million selections, down 4 percent. State-based exchanges showed 7.2 million, down 2 percent. California increased enrollment through its own subsidies, while Texas also gained. These variations expose how blue-state overreach perpetuates dependency, unlike red-state restraint.

officials warn of further disenrollments as households receive first premium bills. Preliminary data captures only plan selections and renewals through January 15 deadlines. Full effectuated enrollment awaits summer 2026 figures. Regional economic factors amplify impacts in the South, where families reject skyrocketing costs tied to federal mismanagement.

Long-Term Path to Sustainable Healthcare

The decline risks ACA risk pool destabilization if healthier individuals exit due to costs. Millions may shift to uninsured status or alternatives, highlighting Obamacare’s flaws. States like California diverge with their subsidies, but national policy under Trump emphasizes individual liberty over endless spending. Economic fallout includes delayed care and productivity losses, yet this resets toward market-driven solutions. Conservatives celebrate reining in globalist-inspired entitlements that fueled inflation and ignored American families.

Watch the report: ACA enrollment drops as premiums skyrocket after tax credits expire