Obamacare Enrollment Expected to Drop by Nearly Five Million as Costs Surge

American Greatness ^ | 05/21/2026

[SeekAndFind]

Enrollment in the Affordable Care Act marketplace is projected to fall by nearly 5 million people this year as rising premiums and higher deductibles force many Americans to reconsider whether they can still afford health insurance coverage, according to a new analysis from healthcare nonprofit KFF.

The report estimates ACA enrollment could decline from 22.3 million participants in 2025 to roughly 17.5 million this year, representing a drop of more than 20 percent.

At the same time, Americans who remain enrolled are paying substantially more out of pocket. According to the analysis, average deductibles have climbed by more than $1,000, while monthly premium payments have increased by an average of $65.

“No matter how you slice it, people are paying more,” said Cynthia Cox, who co-authored the report.

The sharp enrollment decline comes after the expiration of enhanced COVID-era subsidies that had artificially lowered costs for many Obamacare enrollees over the past several years. Without those subsidies, many middle-income Americans are now struggling to keep up with rising monthly payments.

KFF found that middle-income Americans were among the most likely to drop their coverage. Many earn too much to qualify for the remaining low-income subsidies but not enough to comfortably absorb the higher costs now hitting the marketplace.

The ACA marketplace, once promoted as a cornerstone of Democrat healthcare policy, has become increasingly important for gig workers, farmers, ranchers, hairstylists, and self-employed Americans who do not receive employer-sponsored coverage.

According to the report, many consumers were automatically renewed into plans from the previous year, only to discover that costs had risen dramatically after the subsidies expired. In many cases, Americans initially kept their coverage before dropping it later in the year once the monthly bills became unaffordable.

“People are trying to hang on to their health insurance coverage any way they can, even if that means they have a deductible of $7,000,” Cox said.

The report found that enrollment declines occurred across most states, although states operating their own healthcare exchanges generally retained more participants than states relying on the federal marketplace.

The Trump administration has argued that some of the enrollment decline stems from efforts to remove fraud and improper enrollments from the ACA system. Federal officials have not yet released final 2026 enrollment figures.

KFF had previously projected that premiums could more than double after the COVID-era subsidies ended. The new analysis found that premiums instead rose by an average of 58 percent, partly because many Americans switched into cheaper plans with significantly higher deductibles and reduced coverage.

The rising costs and shrinking enrollment are expected to become a major issue heading into the midterm elections as voters increasingly focus on inflation, affordability, and broader economic pressures.

Cox suggested insurers may now be adjusting to the post-subsidy market environment, potentially reducing the likelihood of another major premium spike next year.

“I’m hopeful that this could be a one-time market correction,” she said.

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TOPICS: Business/Economy; Culture/Society; Government; News/Current Events
KEYWORDS: enrollment; fail; healthcare; obamacare; ohahacare; socializedmedicine

[ProgressingAmerica]

Enrollment could go to zero. The GOP will never abolish it as they should.

[DIRTYSECRET]

Trump has no obligation to save Obamacare. It didn’t get one republican vote in congress. Sounds like he’s gonna have to let it ‘wither’ on the vine until the people are ready for something else-not before. It’s an opportunity just as Cuba with no electricity and the Chicoms with no Iran oil.

All Thump has to say is his plan will cover EVERYBODY-the magic word. At this point the public has a hard time believing the left.

[quantim]

“The GOP will never abolish it as they should.”

The RINO/GOPe class proved it too, these sellouts made absolutely no changes in Trump’s first term when they could have improved Hussein’s Havoc (AKA Obamacare). And can’t pass the SAVE ACT? Tell me again why people should go and vote for more of this in the fall, could get even uglier.

[Nateman]

It was disaster from day one. By design. The plan was it was going to be boosted up to full scale Socialized medicine. Fortunately while this POS was not repealed the requirement we had to pay a fee for not having health insurance was repealed. At least with car insurance you can avoid being forced to buy it by not driving a car. How would you avoid paying for Obamacare if that penalty was still in effect?

[Paladin2]

Make Br0nc0 Bama’s personnal accounts pay the annual increases.

It’ Bammy’s [and Traitor Roberts’] fault afterall.

[Bubba_Leroy]

But Obamacare has been working exactly as intended. Create the worst healthcare system imaginable and force the sheeple to beg for socialized medicine.

[ProtectOurFreedom]

Pelosi and Dems..."We fixed health care once and for all. With this passage of Obamacare, you'll never have to worry about health insurance ever again. You will be free to pursue your dreams like being a poet without fear of losing your coverage."

That aged real well.

[Henry Hnyellar]

Spendy Horror and Nancy Piglosi celebrate.

[ProtectOurFreedom]

In March 2010, CNN wrote...

Pelosi emerges as powerhouse in D.C.

By Julian E. Zelizer, Special to CNN

Princeton, New Jersey (CNN) -- The passage of health care will certainly rank as one of the major political achievements of recent decades. [LOLOL - Flop!]

Legislation that will eventually extend health care coverage to more than 30 million more Americans, greatly expand the number of options that citizens have when purchasing health care, bring healthy citizens into the pool of the insured and thus lower costs and create important regulations on health care companies will be remembered as one of the biggest domestic policy changes since the Great Society of the 1960s [another super-stinker].

While most attention will focus on President Obama for pulling off a Herculean task that eluded many of our great presidents, U.S. House Speaker Nancy Pelosi emerges from this battle as the real powerhouse in Washington. She has pursued a clear ideological agenda but through pragmatic political tactics. Like the late Sen. Ted Kennedy, she stands for something, yet knows how to round up votes.

Since the 2008 election, Pelosi has been the most reliable leader Democrats have had. She has delivered on almost all of the legislation that the White House sent to Congress, even as her colleagues found themselves frustrated by a Senate that seemed incapable of governance.

First, she assembled a center-left coalition around the original House bill in November by pushing through a controversial amendment related to abortion that brought moderate Democrats on board with the legislation.

Second, when many Democrats, including top presidential advisers such as Rahm Emanuel, contemplated breaking up the bill after the Massachusetts election, Pelosi stood firm and defended holistic reform.

She "kept the steel in the President's back," Democrat Rep. Anna Eshoo told Politico. Finally, in the past week she displayed the kind of vote-gathering skills that have been displayed by legendary figures such as Speaker Sam Rayburn of Texas.

This turd still reeks to high heaven. CNN isn't singing Pelosi's praises much any more for passing Obamacare.

[basalt]

Lawyers working on a “contingency” basis ruined the health care system. Medical cases are the only time law firms do that stuff. Malpractice insurance skyrocketed once the lawsuits started flying. Start reform there.

[basalt]

and they never talk about the mammoth, historic mid-term wipe out 2 years later....biggest mid-term loss in almost 100 years.

[Golden Eagle]

These people will be left without insurance is the bottom line. The GOP is long overdue coming up with some alternative.

[DIRTYSECRET]

I say get rid of Obamacare FIRST before any new Trump plan gets discussed. No replacement. Just give a timeline for it to end. Then go to work on the Trump plan effective when the old one dies. The senate had 60 senate seats back then and we won’t need it as the public will go with nothing otherwise.

[Varsity Flight]

BodyMortgage. Satan.

[Brian Griffin]

My proposal for

PPACA AFFORDABILITY

Silver plans would be limited to a maximum deductible of three times the Medicare Part A amount [2026: $1736].

I would also make bronze plans low cost by having $10,000 50% co-pays with $10,000 paid up front to the insurance company by the insured. Unused amounts of the $10,000s would be refunded after the policy is closed out.

I would also make copper plans low cost by only covering Part A scope items plus what Part B would pay for any general or regional anesthesia surgery.

I would allow Federal PPACA exchanges to offer Interstate Class Drug Plans,
exempt from state control that cover under contract at the time of policy issue at least:
1. 80% of all FDA-approved recombinant drugs by key active entity
2. 80% of all key FDA breakthrough chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
3. 80% of all key chemical active entities under patent as of January 1 of the coverage year
used in a drug approved by the FDA by August 1 prior
4. 90% of all WHO “essential” drugs

Interstate Class Drug Plans that don’t meet all those minimums could be sold off the exchanges.

This system would allow for genuine negotiation between drug plans and drug companies. Drug plans would have an incentive to try to buy drugs from drug companies and drug companies would have an incentive to make deals to make sales.

Plan formulary drugs would be supplied on an all-the-doctors prescribe basis. The co-pays on plan formulary drugs would be roughly equal to mere manufacturing cost.

Non-formulary drugs might be covered by timed vouchers with plan-set amounts ($700 plan pay, 30-day supply, TV_Drug_32, to be dispensed by plan-listed pharmacy in June 2026). Voucher plans would not have fixed premiums.

Voucher issuance would require individual approval by a plan (or third party) reviewer. The prescriber would normally have to fill out an online request questionnaire.

The copper, bronze and Interstate Class Drug Plans would not be subsidy eligible.

[Golden Eagle]

It really needs to be done at the same time, to ensure that only a single, efficient transition between old and new is required, but more importantly, to ensure people aren’t left without anything while politicians fight it out over who gets their cut of the final product.

I also know the hardcore right position is, no meals, much less insurance, is free, and subscribe to that generally speaking. However, when I see how much money is thrown away on other, less important things, and compared to how people literally die without health insurance, I think the spending for it deserves a higher priority on the overall list.

[Brian Griffin]

What you do is to offer strong market force plans to individual buyers that get little or no federal subsidy money.

Within a few years anybody paying a substantial premium will want to pay less for the strong market force plans.

Within a few more years, the Gimmes can be switched over as freeloaders shouldn’t get Cadillacs when those that pay get Chevys and Buicks.

[Brian Griffin]

The medical system needs reform:
1. Break most hospitals into two highly competitive entities.
2. Convert other hospitals into real estate leasing entities with competing surgical suites and nursing wings.
3. Separate out drug coverage so hospital systems can run care coverage systems and cut out insurance company overhead and meddlers.
4. Create interstate drug plans that don’t have to pay what the drugmaker wants for every drug. To qualify for exchange listing and federal subsidies, they would have to most (~80% or more) in all important types (large volume recombinant, small volume recombinant, breakthroughs under patent, etc.). Group and exchange plans to offer time-limited vouchers at plan set amounts for out-of-formulary drugs. Voucher plans would have variable premiums. Plans without minimums (or vouchers) could be vended directly to individuals and families.
5. These plans would be all the doctors (and AI) prescribe for formulary drugs with co-pays equal to manufacturing cost
6. Reform medical education, breaking down medicine and dentistry into simpler chunks and start it in the first year of college
7. Replace most primary care doctoring with AI.
(Insurers would pay human doctors to confirm AI diagnosis, orders for expensive tests[MRI, genetic], prescribe radiation imaging[CT, PET, X-ray]/treatment, and voucher/government co-pay drugs. Other human doctor care would be private pay.)
8. Radioisotope-related care would be at international airport centers

[Organic Panic]

“Americans who remain enrolled are paying substantially more out of pocket”

While millions and millions of illegals and freeloaders pay nothing.