Ohio saw the largest drop in enrollment after Trump/Republican Affordable Care Act cuts

Ohio is the state that saw the biggest drop in enrollment in health plans under the Affordable Care Act, according to federal data first reported by the Associated Press.

The losses come after the Republican-controlled Congress last year allowed pandemic-era subsidies to buy insurance on ACA exchanges to expire. That caused premiums to double for most of the 25.2 million Americans who got their insurance there.

After the subsidies expired, national enrollment dropped by 2.6 million in February 2026 when compared to February 2025, the AP reported. That's about a 10% drop.

In Ohio, the losses went much deeper.

Enrollment dropped from just under half a million in February 2025 to 336,000 four months ago. That's a loss of nearly a third of enrollees, 32.4% or 161,385 people.

Oklahoma, the state with the next-highest losses, saw a decrease of 32.3%.

Among neighboring states, Michigan and Indiana also saw big losses of more than 25%. Meanwhile, Kentucky and West Virginia lost 14.3% and 13.1%, respectively.

Pennsylvania lost just 1.2% of its enrollees.

Congressional Republicans — including Ohio's senators — allowed the subsidies to expire months after voting in favor of President Donald Trump's Big Beautiful Bill Act.

The legislation kept Trump's 2017 tax cuts from expiring. That provision is estimated to have created a $1 trillion windfall over 10 years for the richest 1% of Americans while the law cut a similar amount from Medicaid and nutrition assistance.

During his first term, Trump tried repeatedly to repeal the ACA — or Obamacare — but he was unsuccessful. However, the provisions in Trump's 2025 spending bill have diminished former President Barack Obama's signature program.

Simply dropping coverage purchased on Obamacare exchanges doesn't mean people didn't get it elsewhere, but some are likely to become uninsured.

The subsidies helped bring down the share of uninsured Americans to its lowest level ever. With them expiring Dec. 31 and with the Trump bill's Medicaid cuts, it's reasonable to assume that the portion of Ohioans who lack health insurance is going to go up substantially this year, said Natasha Murphy, health policy director at the Center for American Progress.

"While it's still too early to quantify the full increase in the uninsured population for 2026, the direction is becoming increasingly clear," Murphy said in an email. "Early marketplace enrollment data already show coverage declines, and the combination of the loss of enhanced premium tax credits and other recent federal policy changes is making health insurance harder to afford, leaving many families without a realistic alternative."

The cuts to Medicaid are also leading some insurers to exit states that expanded eligibility to include Americans making 138% or less of federal poverty guidelines. For example, the Arkansas Advocate on Monday reported that Centene — the largest provider of Medicaid managed care in the United States — was exiting that state's Medicaid program.

SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX.

SUPPORT: YOU MAKE OUR WORK POSSIBLE

Courtesy of Ohio Capital Journal