ACA subsidy expiration leaves millions uninsured as premiums more than double (March 19, 2026 )
March 19, 2026 — A KFF survey found that approximately 9 percent of the 22 million Americans who had been enrolled in ACA marketplace plans in 2025 — more than 2 million people — became uninsured after the enhanced premium tax credits expired at the end of 2025, with an additional 17 percent at risk of dropping coverage because they can no longer afford their premiums. For the average ACA enrollee, monthly premiums more than doubled in 2026 following the expiration Congress failed to prevent.
The enhanced premium tax credits, first enacted in 2021 and extended through 2025, had driven record marketplace enrollment — from 12 million in 2021 to a peak of 24.3 million in 2025. About 22 million enrollees (92%) received the subsidies. The One Big Beautiful Bill, signed July 4, 2025, failed to extend them, and the administration opposed renewal without structural changes to the ACA. Estimates had projected 7.3 million people would lose ACA coverage in 2026 as a result; independent projections put the number becoming fully uninsured at between 4.8 and 5 million.
More than half of those who remained enrolled in ACA plans in 2026 reported cutting or planning to cut spending on basic household expenses including food and clothing to afford their health care. The expiration was not a passive lapse — the Trump administration actively opposed clean extensions, and the One Big Beautiful Bill also restricted ACA marketplace eligibility for immigrants and added new verification burdens that made enrollment harder. The Commonwealth Fund found the premium cliff was expected to eliminate hundreds of thousands of jobs and reduce state and local tax revenues nationwide.
| https://www.cnbc.com/2026/03/19/aca-enrollees-uninsured.html |