Enrollment in Affordable Care Act health plans fell by roughly 3 million people this February compared to the same month last year, according to new data from the Department of Health and Human Services. Enrollment declined from 22.1 million people in 2025 to 19.2 million people this year, a drop of 13%.
The HHS report, which was released on Friday, attributed the decrease to the Trump administration’s crackdown on “improper, phantom, or fraudulent” registrations that had swelled enrollment figures under the Biden administration
Health analysts say there’s more to the story. They say that the dramatic drop is more likely due to sharp spikes in healthcare costs following the expiration of enhanced ACA tax credits at the end of last year.
“While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits,” Cynthia Cox, director of the ACA program at healthcare policy research non-profit KFF, wrote in an analysis this week.
Cox projects that enrollment in ACA plans “could continue to erode, possibly reaching an average of 17.5 million enrollees by the end of 2026.”
