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As Affordable Care Act Enrollment Declines and Premiums Increase, Will Congress Take Action?
Federal data show premiums rising as insurers propose another year of double-digit hikes and Congress leaves enhanced subsidies to expire.
Enrollment in the Affordable Care Act declined by nearly 3 million people between 2025 and 2026, marking a sharp reversal after several years of rapid growth, according to federal data.
The Trump administration attributes the decline to its crackdown on fraud, while many Americans face higher costs after Congress allowed pandemic-era financial assistance to expire earlier this year.
Retiree MV Barnes dropped her coverage after premiums rose from $800 to $1,200, while Ohio and Oklahoma lost nearly one-third of enrollees, a decline seen in almost every state.
Sen. Bill Cassidy and President Trump advocate for annual, direct payments of up to $2,000 for families, arguing that direct aid ensures 100% of funds support necessary medical care.
Policy analyst Matt McGough expects enrollment will continue to decrease throughout the year as premium payments squeeze budgets, though reform efforts face uncertainty as Republicans juggle priorities ahead of midterm elections.