Health

Subtopics: Health Reform Medicare Medicaid and CHIP Coverage Trends

ACA Marketplace Enrollment Dropping After Premium Tax Credit Enhancements Allowed to Lapse

Medicaid Enrollment Declining; Drops Likely to Steepen After 2027

Change in enrollment from  to 

Marketplace enrollment includes enrollees with an active plan who have also paid their monthly premium.

Open enrollment shows the number of people who selected plans during the annual open enrollment period, including some who did not subsequently pay their premium and maintain an active plan.

Source: CBPP calculations from Centers for Medicare & Medicaid Services (CMS) and state program data.

Center on Budget and Policy Priorities | cbpp.org
Georgia Medicaid expansion enrollment data reflect people enrolled in its Pathways to Coverage program, who, like Medicaid expansion enrollees, will be subject to the work requirement.
Wisconsin Medicaid expansion enrollment data reflect adults without children who have incomes up to 100% of poverty covered through their 1115 waiver, who, like Medicaid expansion enrollees, will be subject to the work requirement.
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Health Coverage Tracker: Millions of People Are Losing Coverage Following 2025 Republican Policy Changes

September 2, 2026
This tool tracks declines in the number of people enrolled in the ACA marketplaces and Medicaid: two sources of coverage that have been crucial to delivering affordable health care to people with low and moderate incomes. All told, CBO projects that roughly 15 million people will lose health coverage and become uninsured by 2034 due to the 2025 reconciliation law, the decision to let PTC enhancements expire, and other harmful ACA marketplace rule changes made by the Trump Administration.

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Policy Basics

We work to ensure that all people have access to and can easily enroll in affordable health coverage and that Medicaid, Medicare, and the Affordable Care Act marketplaces provide coverage that meets the needs of low-income children and families, older adults, and people with disabilities. We also work to ensure that proposals that would affect these programs do not slash benefits for, or impose costs on, the nation’s most vulnerable people.

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Experts

Nicole Rapfogel

Nicole Rapfogel

Senior Policy Analyst, Marketplace and Private Insurance Policy
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Allie Gardner

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Claire Heylson

Claire Heyison

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Symonne Singleton

Symonne Singleton

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Maani Stewart

Maani Stewart

Senior Policy Analyst
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Laura Guerra-Cardus

Laura Guerra-Cardus

Director of State Medicaid Strategy
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Laura Harker

Laura Harker

Senior Policy Analyst
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Breanna Sharer

Breanna Sharer

Policy Analyst
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Gideon Lukens

Gideon Lukens

Senior Fellow and Director of Research and Data Analysis
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Farah Erzouki

Farah Erzouki

Senior Policy Analyst
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Peggy Bailey

Peggy Bailey

Executive Vice President for Policy and Program Development
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Income Security
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Jennifer Wagner

Jennifer Wagner

Director of Medicaid Eligibility and Enrollment
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Sarah Lueck

Sarah Lueck

Vice President for Health Policy
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Shelby Gonzales

Shelby Gonzales

Vice President for Immigration Policy
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Allison Orris

Allison Orris

Senior Fellow and Director of Medicaid Policy
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