5 million people dropped ACA health insurance after the GOP let prices rise : NPR
NPR Topics: Politics — 2026-06-26 17:54:00 — www.npr.org
President Trump and his administration have attributed a sharp drop in Affordable Care Act (ACA) enrollment to efforts aimed at addressing fraud in the health insurance marketplaces. However, newly released federal data and expert analysis challenge this narrative, pointing instead to skyrocketing premium costs as the primary driver behind the loss of coverage.
ACA Enrollment Plummets as Premiums Rise
According to a report from the Department of Health and Human Services, five million people who had signed up for ACA coverage for 2026 either disenrolled or failed to pay their premiums, resulting in a 13% decrease in enrollment compared to the previous year. This drop coincided with the expiration of enhanced premium tax credits, which had previously made coverage more affordable for millions of Americans.
Trump Administration Cites Fraud, Experts Disagree
The Trump administration has claimed that the enrollment decline is largely due to their crackdown on fraud within the ACA marketplaces. This theory, also advanced by the Paragon Health Institute, a conservative think tank influential in the administration, suggests that previous enrollment growth was suspicious and driven by fraudulent activity.
However, health policy experts are skeptical of this explanation. Cynthia Cox, director of KFF’s Program on the ACA, notes that the marketplace doubled in size during the period when enhanced subsidies were available, making coverage more appealing and affordable. She argues that the loss of coverage is more closely tied to the expiration of these subsidies and the resulting premium increases, rather than widespread fraud.
Stacey Pogue, a senior research fellow at the Georgetown Center on Health Insurance Reforms, echoes this view, stating, “I don’t see data that point to that conclusion that a 5 million person drop can be explained by allegations of fraud. There’s lots of evidence pointing to people making decisions based on what they can pay each month.”
Impact on Consumers and Insurers
The higher health insurance costs have forced many consumers to make difficult decisions about their family budgets, employment, and other aspects of their lives. The situation has also affected insurance companies, with several announcing they will not participate in ACA markets next year due to declining enrollment and a shrinking pool of healthier customers.
Looking Ahead
Premiums for ACA plans are expected to continue rising, which could further reduce enrollment in the coming years. Early rate filings for 2027 indicate that costs will go up again, putting additional pressure on consumers navigating an already challenging health care landscape.
Conclusion
While the Trump administration attributes the drop in ACA enrollment to anti-fraud efforts, the evidence presented by health policy experts and federal data points to the expiration of enhanced subsidies and rising premiums as the true causes. As premiums continue to climb, the affordability and accessibility of health insurance for millions of Americans remain at risk.
Source: https://www.npr.org/2026/06/26/nx-s1-5860746/aca-health-insurance-subsidies-rates-premiums