About 21% of people who enrolled in coverage through Healthcare.gov have dropped out this year, according to a new report.
News outlet NOTUS obtained internal documents from the Centers for Medicare & Medicaid Services and found that more than one in five people who signed up for a plan on the federal exchange were dropped from their coverage in the weeks after, for being unable to pay their first month's premium.
By comparison, 12% of enrollees dropped out of the rolls in the same window in 2025, NOTUS reported.
Sources at the agency told the outlet that CMS is pointing to its efforts to root out fraud as the driving factor behind the higher decline, when that's unlikely to be the case. A CMS spokesperson told NOTUS that fraud in the ACA marketplace "skyrocketed under the Biden administration."
Enrollment on the exchange increased massively following the COVID-19 pandemic, particularly following the passage of the American Rescue Plan Act, which first instituted enhanced premium tax credits that opened the door for more people to find affordable coverage.
The subsidies were later extended with the Inflation Reduction Act, before expiring at the end of 2025. Many people saw their premiums significantly increase without the tax credits in place, and concern about rising costs drove a lengthy government shutdown in the last months of the year.
Data released by CMS as the final look at open enrollment activity found 23.1 million signups during the period, with new signups and automatic renewals both declining year over year.
NOTUS' analysis echoes commentary from insurers during Q1, with major players on the exchanges like Centene and Molina Healthcare seeing a drop off in their marketplace enrollment. Cigna revealed that it will exit the ACA market entirely in 2027 given the added uncertainty.