Pennie cancellations mount as swelling costs drive enrollees away from health insurance

HARRISBURG — The count of Pennsylvanians who dropped "affordable" health care through Pennie, the commonwealth's online marketplace, has grown beyond 100,000 since enhanced premium tax credits once afforded by the federal government weren't extended for 2026.

Devon Trolley, Pennie's executive director, estimated that 104,000 former customers dropped care, largely citing affordability. The total stood at approximately 85,000 at the close of open enrollment on Feb. 1.

The number, she told members of the House Appropriations Committee, grows larger every day.

"Last year, Pennie reached record levels of enrollment due in large part to coverage that was more affordable than ever. However, this year, Pennie enrollees face unprecedented cost increases. Their health care plan cost doubled because Congress did not extend the enhanced premium tax credits which, for years, helped lower cost and increase enrollment," Trolley said Wednesday during a budget hearing for Pennie and the Pennsylvania Insurance Department.

According to Trolley, 471,000 people enrolled for health insurance through Pennie. That figure stood at 497,000 by the close of open enrollment in 2025. The loss of old customers is offset by a gain of new enrollees; however, it is expected that cancellations will continue as bills come due.

"Even people who are enrolled, more than 50 percent said it doesn't fit their budget," Trolley said.

The enhanced premium tax credits were part of the Affordable Care Act and extended within the Inflation Reduction Act of 2022. This year, the Republican-led Congress chose to let the enhanced credits expire amid reports that a proposed extension through 2035 would add $350 billion to the country's budget deficit. Standard tax credits remain in place.

Supporters say it would also have added 3.8 million more people to insurance rolls, prevent hospitals from continuing to accumulate unpaid debt for medical service and overall keep costs down across markets, including commercial markets, because the pool of those insured would be deeper and include healthier people in need of an affordable option.

Insurance Commissioner Michael Humphreys said Congress could act any day to extend the credits, though there's no momentum currently to do so.

"People don't stop getting sick because they don't have health insurance," Humphreys said. "Those who think they can forego insurance are generally the first to pull out of coverage. So, the remaining pool is less healthy compared to those who were in the pool prior. … It impacts, really, the entirety of the health care ecosystem."

The cost of premiums rose 102% on average across Pennsylvania, or an additional $157 each month. The average increase exceeded $200 in 15 counties and topped $300 in seven other counties — all in central, south-central and east-central Pennsylvania.

Most of those dropping coverage are age 55 or older but ineligible for a government subsidized health care plan, or young adults playing the risk of saving money in the hopes they don't get sick or injured, Trolley explained. She added that most of those who dropped coverage are from rural counties.

Gov. Josh Shapiro has repeatedly said that Pennsylvania simply can't afford to backfill the lost funding to extend the enhanced premium tax credits on its own. New Mexico has, according to Trolley. She said that as a result, the state experienced a 14% increase in enrollment.