The Affordable Care Act (ACA) marketplaces have seen a significant decline in enrollment, with 2.6 million Americans losing health insurance coverage in 2025. This drop is largely attributed to the expiration of enhanced premium tax credits, which made coverage more affordable during the COVID-19 pandemic. When these subsidies ended, the average subsidized enrollee's cost to keep the same plan skyrocketed by 114%, leading many to switch to cheaper, higher-deductible plans. As a health economist, I find this trend deeply concerning. The question arises: What happens to people's health when coverage becomes unaffordable? The answer lies in the impact of losing insurance coverage, which can lead to delayed or skipped care, financial strain, and even more severe health consequences. The data released in June 2026 shows a sharp reversal in marketplace coverage, and the health effects will take longer to measure. However, past research offers a clear warning: When coverage disappears, the consequences often appear later in doctors' offices, emergency rooms, and family budgets. This trend highlights the importance of maintaining affordable and accessible health insurance coverage for all Americans.
