One in 5 ACA enrollees in Pa. drops health coverage as costs spike

About 85,000 Pennsylvanians have dropped their Affordable Care Act coverage for 2026 in the face of soaring premium costs from the expiration of federal subsidies.

Pennie officials said about one in five program participants chose to terminate their coverage, at a rate of about 1,000 per day during the open enrollment period. And they expect Pennie will continue to shed enrollment in coming months as people begin feeling the effect of the cost changes.

“This loss of coverage will increase the number of uninsured Pennsylvanians, worsening health outcomes and driving up uncompensated care costs statewide,” Antoinette Kraus, executive director of the Pennsylvania Health Access Network, said in a statement. “As the costs of groceries, housing, utilities and other necessities continue to rise, higher health care costs mean more people will delay care, skip treatments or take on medical debt.”

Commonwealth leaders have urged Congress to extend the enhanced tax credits that helped blunt the expense of Affordable Care Act coverage for many people. Congressional leaders, however, have not agreed on a solution.

The resulting rise in health premiums for 2026 varies based on age, income and location, with Juniata and Fulton counties seeing average jumps of 485% and 411% respectively, according to the state. Across the commonwealth, average premiums were expected to rise by 102%, officials reported.

Pennie enrollment, which closed at the end of January, stands at about 486,000 for 2026 compared to 497,000 the prior year. That total reflects the terminations and the addition of about 79,000 new enrollees, though these sign-ups also lagged compared to 2025, when more than 90,000 people joined Pennie.

Older and rural Pennsylvanians canceled their coverage at the highest rates, as did people whose earnings were just above the so-called income cliff created by the end of the enhanced tax subsidies, according to officials.

Schuylkill, Fulton, Greene, Lancaster and Northampton counties had the highest termination rates in the commonwealth.

In addition, the state reported a sizable increase in the number of people opting for cheaper Pennie plans that will expose them to higher out-of-pocket costs should they need medical care.