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About four million Americans have dropped out of Affordable Care Act insurance coverage this year as costs soared due to the loss of enhanced subsidies.
The figures released late Friday from the Centers for Medicare and Medicaid Services offer the most complete look to date at what happened to enrollment after Republicans in Congress failed to extend enhanced ACA subsidies at the end of last year.
The loss of those subsidies spiked many people’s premiums by double digits; the new coverage numbers likely reflect the sticker shock Americans experienced.
Unable to pay, they dropped their coverage.
The report from the health and human services assistant secretary for planning and evaluation said that an estimated 19.2 million people are enrolled in ACA plans as of February.
That’s a drop of more than 16 percent from the 23 million people who signed up for coverage at the end of open enrollment, which itself was about 1 million fewer than last year.
Health costs will likely play a key role in November’s midterm elections, with Democrats pointing not just to the subsidy expiration, but also to changes from the One Big Beautiful Bill and other Trump regulatory moves.
Democrats shut down the government for a record 45 days last year but failed to get an extension of the enhanced credits in return for their support on voting to reopen the government.
Instead, Republicans promised to give them a vote on a bill of their choosing to extend the subsidies. The vote failed, and the subsidies expired at the start of this year.
ObamaCare enrollment grew sharply during the Biden administration, and the latest numbers are still the highest enrollment of any year before 2024.
Administration officials and congressional Republicans contend the estimates of the numbers of people losing insurance have been overblown. The HHS report focused on fraud and improper enrollments, insisting that the decreased enrollment is because of the Trump administration’s fraud control efforts.
But insurers and health policy experts have been warning that a steep enrollment drop was imminent once people’s first premium bills came due.
Experts have said they are not expecting a “death spiral” in the marketplace or a repeat of 2017 when political uncertainty about the future of the law, combined with rising premiums and plan exits, raised fears of “insurance deserts.”
But falling enrollments as well as large numbers of people switching to less generous, high-deductible bronze plans are contributing to concerns about stability.
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