MNsure enrollment dropped 12% in 2026 after jump in insurance costs

MNsure health insurance enrollment dropped by more than 17,000 in May 2026 compared to May 2025.

The dip in insurance coverage offered on MNsure — the state's Affordable Care Act marketplace — mirrors a nationwide trend in 2026. The drop in coverage was expected after most Republican senators blocked Democratic efforts to extend extra federal subsidies that offset the cost of health care premiums — what people pay upfront to be insured — for millions of Americans since 2021.

Subsidies under the Affordable Care Act offset the cost of health insurance premiums for families who make below 400% of the federal poverty level — in 2026, for example, $132,000 was the cutoff for a household of four. The subsidies were designed to help people who aren't eligible for Medicaid or Medicare but also don't have enough money to pay for unaffordable employer insurance or private insurance.

The extra federal subsidies that Republicans senators blocked are known as "enhanced premium tax credits" because they raised the income cutoffs of people who can receive subsidies and also increased the amount of subsidies for people who were already eligible. Enhanced premium tax credits were implemented in 2021 as part of the COVID-19 stimulus package and extended in 2022.

The enhanced premium tax credits expired at the end of 2025, hiking up health insurance plan costs by 50% for a projected 89,000 Minnesotans, according to a MNsure release in 2025.

Recent federal data show that 19.2 million Americans were actively enrolled in ACA marketplace plans in February 2026, compared to 22.1 million in February 2025 — a 13% drop in enrollment.

Enrollment in Minnesota dropped by a similar rate, according to MNSure data: 142,977 MNsure enrolled in 2025 compared to 125,714 in 2026 — a 12% drop in enrollment.

The U.S. Department of Health and Human Services attributed the drop in active enrollment to program integrity efforts by the Trump administration. It claimed that the enhanced premium tax credits, which led to a wider availability of $0 premium plans, "created the incentive and opportunity for fraudulent, phantom and improper enrollments," including people enrolled without their knowledge by insurance brokers.

Health policy experts, who predicted a steep drop in enrollments in 2026 because of increased costs, are skeptical that the difference stems from the Trump administration's program integrity measures.

"While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments — often in the double or even triple digits — with the expiration of enhanced tax credits," wrote Cynthia Cox at KFF, a health policy research organization.

Premium payments for ACA marketplace enrollees increased by an average of 58%, from $113 to $178 per month, according to a KFF analysis. That figure doesn't account for people who dropped coverage because the increase was too high.

Insurance deductibles — the amount that people have to pay for health care before their insurance kicks in — also rose in ACA marketplaces to a record high of $3,786 in 2026, in part because people switched to cheaper health insurance plans, which have high deductibles, as a response to hiked premium costs, according to the KFF analysis.

Courtesy of Minnesota Reformer