KFF: Individual health insurance enrollment fell 18 percent in June

Enrollment in ObamaCare and other health insurance plans on the individual market dropped by more than 4.5 million people over the past year, according to an analysis by health research organization KFF.

Enrollment fell from 25.2 million in 2025 to 20.5 million in June 2026, an 18 percent drop — the largest year-to-year decrease since 2015. The decline coincides with the expiration of COVID-era enhanced premium tax credits as well as other Trump administration policy changes.

Previous federal data showed that, after Congress let the enhanced subsidies expire at the end of 2025, enrollment in the Affordable Care Act (ACA) exchanges fell 12 percent, the first decrease in seven years.

The Congressional Budget Office forecast in July that , due to the loss of the enhanced subsidies, ACA exchange enrollment may fall to pre-COVID levels.

New Mexico, the one state that replaced the federal subsidies with its own funding, was the only state where enrollment in ACA plans grew.

Data on the individual market — which is comprised mostly of ACA plans — suggests enrollment fell 16 percent as of March and 18 percent as of June, KFF found.

“This drop in enrollment was not completely unexpected,” said Justin Lo, a senior researcher for the KFF’s Program on the ACA, who also co-authored the analysis.

Lo noted that a survey KFF conducted at the start of the year found 17 percent of enrollees thought they would not be able to make all their premium payments for 2026, which put them at risk of losing coverage at some point this year.

“We would also expect that as the year progresses, more people might also be losing their coverage due to not being able to pay their premiums,” Lo said.

The June figures do not account for the drop in enrollment expected from the Trump administration’s recent announcement that it is cancelling ObamaCare plans for 760,000 people due to instances of alleged fraud.

While enrollment has fallen sharply this year and premiums have increased, overall enrollment is still up by seven million from 2019, before the introduction of the enhanced subsidies.

For people in the lowest tax brackets, Lo said ACA plans are still relatively affordable.