It\u2019s\u00a0February,\u00a0so\u00a0open enrollment for the\u00a0Affordable Care Act\u00a0is over.\u00a0We\u2019re\u00a0getting\u00a0the\u00a0first glimpses\u00a0of\u00a0how sign-ups are shaking out\u00a0after the\u00a0expiration\u00a0of enhanced subsidies that helped most people with their premium costs.\u00a0<\/p>\n
While more Americans enrolled than\u00a0some policy analysts had\u00a0expected<\/a>, the number\u00a0was\u00a0still 1.2 million below<\/a>\u00a0what\u00a0it was\u00a0at the same time last year. And experts say\u00a0it will\u00a0be\u00a0months\u00a0until\u00a0the numbers\u00a0are final.\u00a0The timing\u00a0will depend on\u00a0how many of those people\u00a0who signed up for coverage\u00a0actually pay their premiums and remain enrolled.\u00a0<\/p>\n In coming weeks, \u201cconsumers may find they really can\u2019t afford the premiums and cancel their plans, while carriers may also cancel coverage for nonpayment,\u201d said Pat Kelly, executive director of Your Health Idaho, a state-based ACA marketplace, during a Jan. 22 call with reporters.\u00a0<\/p>\n The drop comes after several years of record-breaking enrollment, with\u00a024.2\u00a0million\u00a0sign-ups for the 2025 enrollment year.\u00a0Enrollment growth took off after enhanced subsidies\u00a0\u2014\u00a0which lowered the amount most households had to pay\u00a0out\u00a0of their own income toward premiums and removed an\u00a0upper-income\u00a0cap\u00a0\u2014\u00a0went into effect during the Biden administration. Lawmakers, in adopting the\u00a0enhanced subsidies, set\u00a0an expiration\u00a0date of Dec. 31, 2025.\u00a0<\/p>\n Congressional debate\u00a0over extending\u00a0those\u00a0more generous subsidies\u00a0was heated, even\u00a0leading to the longest-ever government shutdown<\/a>.\u00a0Now, the subsidies are back to their original level,\u00a0and people who earn more than\u00a0four\u00a0times the federal poverty rate (about\u00a0$62,600\u00a0for an individual or\u00a0$84,600\u00a0for a couple)\u00a0can\u2019t\u00a0qualify for any at all.\u00a0<\/p>\n Falling enrollment was seen<\/a>\u00a0in most states this year, with\u00a0the biggest drop in North Carolina, where sign-ups fell by\u00a0nearly 22%,\u00a0federal data shows<\/a>.\u00a0<\/p>\n In a few places \u2014 including New Mexico, Texas, and Maryland, as well as the District of Columbia \u2014 the number of people selecting ACA plans increased.\u00a0<\/p>\n The jump was largest in New Mexico, with its\u00a0tally\u00a0of people selecting plans up by\u00a0nearly\u00a018%. Increases were in the single digits in the other\u00a0states\u00a0and Washington, D.C.\u00a0<\/p>\n New Mexico \u2014 uniquely \u2014 used its own tax dollars to fully offset the loss of the more generous federal tax subsidies for all consumers.\u00a0A few other states<\/a>, including California, Colorado, Maryland, and Washington, used state money to help some enrollees.\u00a0<\/p>\n We\u2019ll\u00a0keep watching to see how this unfolds over the coming weeks.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n