NEPA sees health insurance enrollment drop after enhanced subsidy cuts

More than 9,000 local residents have dropped their health insurance since Congress failed to extend enhanced American Care Act tax credits last year.

When the federal tax credits expired, premiums skyrocketed for working families across Pennsylvania, making it financially impossible for thousands to afford, according to the Center for American Progress, a Washington, D.C.-based public policy research and advocacy organization.

"Choosing between rent, food, and basic healthcare is a choice no family should have to make, said Natasha Murphy, director of health policy at the Center for American Progress.

"Rising costs are forcing Pennsylvanians to drop coverage, deferring routine and preventive care, which will turn conditions that could have been managed affordably into life-threatening emergencies. It's critical that federal lawmakers restore the ACA's enhanced tax credits before Americans face even higher costs in 2027," Murphy said.

Murphy said about 177,000 Pennsylvanians have dropped their healthcare coverage through Pennie, Pennsylvania's official health and dental insurance marketplace, this year.

She provided data from Pennie showing decreases in health insurance marketplace enrollment this year for the following counties as of July 1:

Luzerne – 4,684

Lackawanna – 2,754

Schuylkill – 1,948

Pennie also saw new enrollments decrease from 90,462 in 2025 to 79,462 in 2026 — a 12% drop, Murphy noted.

Nationally, 2026 enrollment in the ACA Marketplace decreased about 17% since January, from about 23.1 million to about 19.2 million, according to the U.S. Department of Health and Human Services.

President Donald Trump's Administration has attributed the reduction to a crackdown on fraud, with Centers for Medicare and Medicaid Services and HHS, pointing to CMS ending premium subsidies for nearly 1.5 million people found to be ineligible for financial assistance or enrolled without their authorization.

Advocacy agencies, however, say there is little evidence that a crackdown on fraud has led to such a drastic decrease in enrollment.

Jen Huber, a registered nurse for 23 years working at Geisinger Community Medical Center in Scranton, said she has seen more patients at the hospital having problems affording the costs.

"They get put on new prescriptions. Some have never been on medication ever, and now they leave the hospital and they're on four or five different medications," Huber said. "Their cost might be $20 a month, and I've seen people walk away with prescriptions that are like $200, $300, $400, sometimes $800 a month. Some people can't afford it, and some people are OK with the cost. But, you're seeing more and more people who are not OK with the cost."

When patients lose their healthcare coverage, Huber said, they don't stop needing health care.

"They just put their primary care and all of their needs aside, just to survive, and then, unfortunately their conditions become more serious," Huber said. "Slowly but surely, we're starting to see more and more. I haven't seen this in a long time. It's been like 15 to 18 years I haven't seen that, and now we're starting to see an uptick in it."

"When they lose their access, patients suffer, families suffer and the strain ultimately will eventually reach the nurses and the entire healthcare system," she said. "People are waiting so long for beds. A patient leaves, and the bed flips over, … there's another person waiting for that bed, and they've been waiting for over 24 hours, 48 hours, sometimes three days, for a bed, and that that's terrible."

In addition to a loss of enhanced subsidies, people are also being slammed with annual increases in insurance costs.

In 2026, nine insurers that provide coverage in Luzerne, Lackawanna and/or Schuylkill counties increased premiums between 11.6% and 37.9%, with only one insurer – Partners Insurance Company – reducing rates by 10%.

Requested rate changes from those insurance companies for 2027 range between 10.5% and 40.9%, according to the Pennsylvania Department of Insurance.