Where Obamacare enrollment is plummeting

Ohio, Oklahoma, Arizona, South Carolina and Minnesota have sustained some of the deepest losses in https://www.axios.com/2026/02/10/obamacare-trump-coverage-rules" target="_blank">Obamacare coverage since beefed-up federal subsidies expired this year, according to state-by-state https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/health-insurance-marketplace/health-insurance-exchanges-monthly-effectuated-enrollment/" target="_blank">federal data.

Why it matters: The coverage losses are hitting deep-red states as well as blue ones after Congress https://www.axios.com/2025/12/05/republicans-aca-health-care-subsidies" target="_blank">let the subsidies expire.

By the numbers: Ohio and Oklahoma each lost nearly a third of their Obamacare enrollment since last year, with other states' coverage dropping more than a quarter, according to the state breakdown, first reported by the Associated Press.

• Indiana, Michigan, Mississippi and Louisiana also had deep coverage losses.
• Nationally, Obamacare enrollment fell by about 3 million since last year, or about 13%, according to a separate https://aspe.hhs.gov/reports/aca-exchange-enrollment-2026" target="_blank">federal report from the Department of Health and Human Services last month.
• That report attributed the drop-off to improper or fraudulent sign-ups by "phantom enrollees." But health policy experts have pointed to large numbers of people not paying their first ACA premium following the expiration of subsidies.
• The pandemic-era enhanced subsidies that Democrats passed in 2021 have https://www.axios.com/pro/health-care-policy/2023/11/06/republicans-aca-subsidies-red-states-insurance" target="_blank">overwhelmingly benefited red states, especially those that haven't expanded Medicaid, according to analysts.

What we're watching: How Republican candidates in the midterms talk about Obamacare subsidies and the coverage losses — if they talk about them at all. (We know what Democrats https://www.axios.com/2026/05/12/aca-medicaid-republicans-uninsured-elections" target="_blank">are going to say.)