The share of Affordable Care Act insurance customers in plans that cost more than $6,000 a year doubled, a sign of the squeeze on household budgets after Congress let Covid-era assistance expire.
The US Centers for Medicare and Medicaid Services posted data late Friday on ACA plans, also called Obamacare, that showed total enrollment this year dipping by about 5% to 23.1 million. That figure doesn’t yet count people who still may drop off plans because they can’t pay premiums, so the decline is expected to deepen.
The share of people paying more than $500 a month — or $6,000 a year — is 8%, double the level of the previous four years, according to CMS data.
The report shows how the distribution of costs has shifted, with more people paying higher premiums since enhanced subsidies expired at the end of 2025. Far fewer people are getting free or low-cost plans, while the proportion paying the highest prices is rising, according to data from the federal HealthCare.gov site, which covers 30 states.
A growing percentage of Obamacare customers willing to pay the highest premiums may signal that the pool of recipients is skewing toward those with significant health care needs, as healthier members drop off due to rising costs. This would be problematic, given the program depends on payments from healthy individuals to help offset the higher costs associated with customers that need more expensive treatment.
Despite the dip in customers, the Trump administration touted the enrollment numbers as a sign of “strength and stability” in the ACA marketplaces on Friday. Two days later, President Donald Trump renewed calls for the ACA to be replaced with direct payments to individuals, a proposal his administration hasn’t detailed. “ObamaCare is not and, never has been, sustainable!” Trump posted on social media.
Data on the number of people who drop off because they can’t pay premiums is expected this spring, CMS said.