Editorial: Americans losing health coverage

Americans who had trouble finding health care insurance found it under the Affordable Care Act passed during the Obama administration. However, over the past year, millions of them lost their coverage.

Ohio and Oklahoma each lost nearly one-third of their enrollees, according to new federal data that provides the first complete 50-state breakdown of sharp enrollment declines following the Jan. 1 expiration of enhanced federal subsidies.

An AP analysis of the data finds that Ohio and Oklahoma each saw a more than 32% decline in ACA enrollment over the past year. They lost larger shares of their covered populations than any other state.

Following closely behind and losing more than one-fourth of their enrollees, were Arizona, South Carolina, Minnesota, Indiana, Michigan, Mississippi, Louisiana and Missouri.

Changes in each state's insured population led to around 2.6 million fewer Americans having Obamacare plans in February compared with the same time last year.

Cynthia Cox, a vice president and director of the health law program at the healthcare research nonprofit KFF, reviewed the latest data. She said it accounts for people who were retroactively removed from coverage after a nonpayment grace period ended.

Cox said, "It's in line with our expectations, but it does show a very steep drop in the number of people with ACA coverage."

Health analysts who have kept a close eye on changes in marketplace enrollment since the health subsidies expired said many Americans' monthly health insurance fees doubled or tripled, forcing some of them to forgo coverage entirely.

In a report released last week, the U.S. Department of Health and Human Services suggested the significant drop in enrollment this year could be attributed to a federal crackdown on fraudulent or "phantom" enrollment. However, analysts have said it was more likely related to the Jan. 1 expiration of federal subsidies, and other changes, including tightened requirements on which immigrants could access subsidized plans.

Florida, a state that relies highly on ACA insurance in part because it did not expand Medicaid and is home to many gig workers and entrepreneurs, still has more residence in the marketplace than any other state, at nearly 4 million. But it also saw the highest number of enrollees drop coverage this year — around 443,000.

The data doesn't show whether people who dropped ACA health insurance this year found coverage elsewhere, but chances are some of them became insured somewhere. But Cox said most people who left the marketplace are likely going without insurance, because it is typically a "place of last resort" to get health coverage for people who aren't eligible elsewhere

Only one state saw an increase in its covered population. New Mexico gained some 14% more enrollees in the government health insurance program compared with the same time last year. It was the only state in the nation that fully replaced the lost federal subsidies using its own funds.

The New Mexico situation is proof that the federal subsidies that were ended are a major cause of 2.3 million Americans losing their healthcare coverage. Congress definitely dropped the ball on this one.