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ACA Subsidy End Leaves 4.8 M Uninsured, Texas Leads

7/19/2026

48 8 Full Breakdown

Center

ACA Subsidies Expire

The loss of ACA premium subsidies created the largest single insurance coverage shock in recent years.
ACA premium tax credits expired on Dec 31 2025 because Congress had not extended them by July 2026, causing coverage to fall.
The Urban Institute estimates 4.8 million lost coverage in 2026, raising the uninsured rate by 21 %.
Projected uninsured growth is highest in Texas (39 %), Florida (29 %) and South Carolina (50 %).

Left

ACA Enrollment Plummets

Millions of Americans faced paying more than double to keep the same ACA marketplace plan, prompting many to drop coverage.
ACA marketplace enrollment fell from 21.8 million in February 2025 to 19.2 million in February 2026, a 12% drop.
After coverage gaps, ER visits and hospitalizations for diabetes and asthma more than doubled.
Insurers seek a typical 14% premium increase for 2027, a second year of double-digit hikes.

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ACA Subsidies Expire

The loss of ACA premium subsidies created the largest single insurance coverage shock in recent years.
ACA premium tax credits expired on Dec 31 2025 because Congress had not extended them by July 2026, causing coverage to fall.
The Urban Institute estimates 4.8 million lost coverage in 2026, raising the uninsured rate by 21 %.
Projected uninsured growth is highest in Texas (39 %), Florida (29 %) and South Carolina (50 %).

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