Enrollment in Affordable Care Act health plans drops by 3M, HHS data reveals
New data from the U.S. Department of Health and Human Services (HHS) reveals that enrollment in health plans sold through government exchanges established as part of the Affordable Care Act (ACA) declined more than previously thought.
Released last week, HHS numbers show that enrollment in health plans sold through ACA exchanges dropped by 3 million, leaving more Americans to find medical coverage elsewhere—or potentially not at all.
Year over year, that is a 13% drop, coming after an end to expanded subsidies that made insurance through federal and state exchanges more affordable.
Currently, 19.2 million Americans are enrolled in ACA-associated plans, HHS confirmed. The reason for the drop, by the agency’s own admission, was because Congress failed to fund an extension of the enhanced subsidies used to pay for health insurance, leaving patients to foot the entire bill in many cases.
However, HHS claims—without providing any direct evidence—that the burst of enrollment seen after the COVID-19 pandemic-era subsidies were put into place was in large part due to “improper, phantom or fraudulent” signups.
“Enrollment that is improper or fraudulent is enrollment by individuals misstating their income to gain access to free plans. Phantom enrollees are unknowingly enrolled in free plans by brokers or auto enrolled. By our estimate, improper, phantom and fraudulent enrollment peaked at 5.6 million people in 2025,” HHS wrote.
The agency added that, with 19.2 million enrolled, that still exceeds any level seen before 2024.
It went on to praise President Donald Trump’s administration for cracking down on “waste, fraud, abuse,” which it associated with the 3 million fewer signups.
Shutdown showdown in the rearview
Notably, the issue of extending the subsidies led to the longest shutdown of the federal government in history, with Democrats backing their renewal.
That lockout ended in 43 days without concessions from Republicans, and the subsidies were not renewed.
In place currently are the original subsidies put in place by the ACA, suitable only for Americans pegged at 100%-400% of the Federal Poverty Level (FPL), beginning at $15,650 for a single-person household and capping off at $62,600.
Chad is an award-winning writer and editor with over 15 years of experience working in media. He has a decade-long professional background in healthcare, working as a writer and in public relations.