More than 160,000 Pennsylvanians have dropped Affordable Care Act health plans this year after federal premium subsidies expired, marketplace officials confirmed Tuesday.
Pennie, the state’s ACA marketplace, reported that one in three enrollees from 2025 canceled coverage by the end of May, including nearly 55,000 in the Philadelphia region. Costs more than doubled on average after Congress failed to renew enhanced tax credits that capped premiums at 8.5% of income.
“People want to have coverage, they see the value and the protection it provides,” said Devon Trolley, Pennie’s executive director. “And when they can afford it, they enroll.”
Marketplace leaders said many families tried to keep coverage but found even cheaper plans unaffordable. “It means that people are going to go uninsured,” said Antoinette Kraus, executive director of the Pennsylvania Health Access Network. “They’ll delay getting care, get sicker and end up in the emergency department with conditions that could have been prevented.”
Dropouts have been highest among residents aged 55 and older and among households earning 150–200% of the federal poverty level. Incomes in that range are $23,475 to $31,300 for an individual and $48,225 to $64,300 for a family of four.
Enrollment losses are expected to stabilize, but new federal rules will shorten open enrollment this fall and bar certain immigrant groups from marketplace, Medicaid, and Medicare coverage, leaving the future of Pennsylvania’s ACA marketplace uncertain.
Pennsylvania Health Insurance Costs Spark Debate Over Coverage Losses
As residents discussed the loss of health coverage and rising costs, many focused on the financial strain of maintaining insurance after federal assistance expired.
One person wrote, “Got laid off. Health care went from $120 to $550. Luckily I got a new job.” Another said, “Mine went up $1200 this year for my family of four, and that includes downgrading to the cheapest plan in 2026. Not really sustainable.”
Several people described dropping coverage altogether. One user stated, “One of them I’ll take the gamble of no insurance. Made it this far without getting sick.” Another wrote, “I dropped it. I couldn’t afford those premiums. Mine went up more than 50%.”
Others questioned how households could absorb the higher costs. “I don’t understand how anybody is able to do this. The amount paid for insurance can be as much as the income from a full time job. What are these people expecting here?” one response said. Anotiiher added, “My husband got laid off not long after we had a baby. Thank God for my mother in law. She’s covering the 2k a month for Cobra until he finds another job. It’s scary out there.”
Some comments reflected broader frustration about affordability and economic security. One user wrote, “There really isn’t even a middle. You either have enough money to live ‘The Standard’ or you don’t.” Another said, “The American dream is only real if you’re asleep.”
As federal marketplace changes take effect later this year, officials will be watching to see whether more residents leave Affordable Care Act coverage. For many families, however, the issue is already deeply personal, with rising costs forcing difficult decisions about whether health insurance remains within reach.
