Newly released state enrollment data show ObamaCare coverage losses could be even more severe than initially anticipated, due to Congress’s unwillingness to renew enhanced subsidies.
Monthly enrollment data through April from Arkansas, Colorado, Maryland, Massachusetts, New Mexico and New York showed a significant number of people canceled their coverage or did not pay their premium bills after signing up for coverage in 2026, according to an analysis from Georgetown University.
Federal officials have so far only released data on initial sign-ups during open enrollment, which include people whose coverage was automatically renewed at the end of 2025.
Sign-ups declined during the 2026 open enrollment period by 1.2 million, a 5 percent drop from the prior year and the largest decline in any year since the marketplaces opened in 2014.
But researchers Stacey Pogue and Sabrina Corlette said that’s an incomplete picture, and it’s important to look at what people do after the first premium bill comes due.
Analysts anticipate overall 2026 marketplace enrollment dropping by about 5 million people this year, with more losses to come in 2027 as policies from the One Big Beautiful Bill Act and potential Trump administration regulation changes take effect.
The loss of the enhanced premium subsidies has hit enrollees hard, and health costs will likely play a key role in November’s midterm elections.
Initial data from several state exchanges showed that plan cancellations are up 24 percent compared to March 2025. In states that reported demographics, the people who cancelled were most likely to be middle-income consumers who lost financial help when the enhanced premium tax credits expired.
The lowest-income enrollees were already shielded from rate hikes by state-funded subsidies, and were the only group less likely to drop coverage compared to last year.
Maryland, for instance, saw a 13 percent drop between January and April, compared with 3 percent last year. Arkansas saw a 16 percent decrease, double the amount from 2025.
Massachusetts experienced a 14 percent decline, compared with 6.7 percent last year, while New Mexico experienced a more than 8 percent decrease, compared with just 0.5 percent in 2025.
“While a drop-off in this period is not unexpected, the magnitude of the decrease compared to last year is stark,” Pogue and Corlette wrote. “This is a small sample of states, but these early indicators may not bode well for national outcomes.”