HPIO data snapshot illustrates large decline in Ohio ACA marketplace enrollment

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HPIO has released a new data snapshot on updated Ohio enrollment in the federal ACA marketplace.
 
New analysis from the Associated Press found that Affordable Care Act (ACA) marketplace enrollment has fallen more sharply in Ohio this year than in any other state (Source: “Ohio sees largest Obamacare enrollment rate decline in country as subsidies expire,” Signal Ohio, July 9).
 
The decline followed the expiration of enhanced federal subsidies at the end of 2025. Marketplace enrollment in Ohio fell by 161,000 people between February 2025 and February 2026, a 32.4% decrease, as illustrated above. Even among Ohioans who selected a plan for 2026, many are now losing coverage after missing premium payments.
 
In Ohio, marketplace enrollment remained relatively low until 2021, when Congress passed the American Rescue Plan Act, which included enhanced subsidies for ACA marketplace plans. The legislation also expanded eligibility for these credits, making coverage more affordable and significantly increasing enrollment. Congress did not renew the enhanced subsidies at the end of 2025.
 
As a result, premiums rose this year for nearly all consumers. Marketplace insurers also increased premiums by an average of 18% in 2026, citing higher prices for health services and uncertainty about the future of the marketplace insurance pool. Higher premiums are the main reason marketplace coverage dropped substantially in Ohio and across the country.
 
Created as part of the ACA in 2010, health insurance marketplaces are a source of coverage for people whose income is too high for Medicaid, but don’t have access to affordable insurance through their employer. Last year, HPIO released a policy explainer on federal policy changes to the federal health insurance marketplace.