ACA marketplace enrollment fell about 3 million to 19.2 million in February 2026, HHS data shows

According to CNBC, enrollment in health insurance plans bought on the Affordable Care Act (ACA) marketplace fell by roughly 3 million people, or about 13%, to 19.2 million in February 2026 from 22.1 million at the end of 2025, based on Department of Health and Human Services (HHS) data issued last week. CNBC reported it was the first drop in ACA enrollment since the first Trump administration and the largest decline since the marketplaces were established in 2014; the data provided the first look at “effectuated” enrollment since enhanced ACA premium subsidies lapsed at the end of 2025. HHS said efforts to crack down on “improper, phantom and fraudulent enrollment” helped drive the decline, including the Centers for Medicare & Medicaid Services canceling coverage for 250,000 people enrolled without their consent, while health policy experts cited higher costs after the subsidy lapse, with KFF estimating average premiums rose 114% to $1,904 in 2026 from $888 in 2025. The Congressional Budget Office estimated in February that ACA marketplace enrollment will fall to 12.5 million by 2028 and that the uninsured share of the U.S. population is expected to rise from 7.6% in 2025 to 10.4% by the end of the decade.