Ohio has seen the largest decline in Affordable Care Act (ACA) enrollment in the country, with a 32.4% drop in enrollment from February 2025 to February 2026. The state’s ACA rolls decreased from 497,443 people to 336,058 people, nearly triple the national average. This decline comes after the expiration of federal subsidies that helped individuals afford their monthly premiums.
Causes of the Decline
Industry analysts attribute the decline to the end of enhanced subsidies, which caused a 58% average increase in out-of-pocket premiums for ACA plans in 2026. The Trump administration, however, suggests that an anti-fraud crackdown is the reason for the decline. Ohio’s large drop may also be due to the state’s decision to use the federal marketplace program instead of setting up its own state exchange.
Some health insurance providers, including Caresource, an Ohio-based company, have announced that they will not offer ACA plans in 2027. This decision may further exacerbate the decline in enrollment. The Ohio Association of Health Plans CEO, Kelly O’Reilly, expressed concern that the end of subsidies would lead to a decline in enrollment, which would result in higher health insurance costs for all Ohioans.
Original reporting: Signal Cleveland — read the source article.
