ACA Enrollment Falls 18% to 20.5 Million, KFF Says
KFF data show U.S. individual-market health insurance enrollment fell 18% year over year, to 20.5 million in June 2026—the steepest annual decline since 2015. The loss follows the expiration of enhanced ACA premium tax credits, which had made coverage more affordable, while premiums and out-of-pocket costs have risen; many enrollees have shifted to lower-premium plans with higher deductibles. Insurers cite a higher-risk mix of members and medical-cost pressures as they seek substantial premium increases, and KFF expects enrollment losses to continue. The decline is also affecting local communities, including Central Valley congressional districts, while Ohio advocates warn that coverage losses could worsen access to care and strain hospitals.
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