Republican from Ohio, American Sen. Jon Husted (left) and Bernie Moreno (right). (Official photos.)
Ohio is the state that has seen the largest decline in enrollment in health care plans under the Affordable Care Act, according to federal data which was first reported by the Associated Press.
The losses came after the Republican-controlled Congress last year allowed pandemic-era subsidies to expire for purchasing insurance on the ACA exchanges. This resulted in premiums doubling in most cases 25.2 million Americans who bought the insurance there.
As the AP reported, after the subsidy expired in February 2026, national school enrollment dropped by 2.6 million compared to February 2025. That’s about a 10% decline.
In Ohio, the losses were much deeper.
Enrollments have dropped from just under half a million in February 2025 to 336,000 four months ago. This means a loss of almost one third of the enrollees, 32.4%, or 161,385 people.
Oklahoma, the state with the next largest losses, saw a decline of 32.3%.
Among neighboring states, Michigan and Indiana also saw immense 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.
Republicans in Congress – including Ohio’s senators – allowed the grants to expire months after voting for President Donald Trump’s Big Beautiful Act.
This legislation will ensure that Trump’s 2017 tax cuts will not expire. It is estimated that this reserve has been created windfall of $1 trillion over 10 years for the richest 1%. Americans while the law cut a similar amount from Medicaid and nutritional assistance.
During his first term, Trump he tried many times to repeal the ACA – i.e. Obamacare – but he failed. However, the provisions of Trump’s 2025 budget bill weakened the program signed by former President Barack Obama.
Just because people drop insurance purchased on the Obamacare exchanges doesn’t mean people didn’t get it elsewhere, but some people will likely become uninsured.
The subsidies helped reduce the number of uninsured Americans to approximately lowest level ever. Because they expire on Dec. 31 and because of the Medicaid cuts included in Trump’s bill, it’s reasonable to assume that the percentage of Ohioans without health insurance will raise significantly this year, said Natasha Murphy, director of health policy at the Center for American Progress.
“While it is still too early to quantify the full increase in the uninsured population in 2026, the direction is becoming clearer,” Murphy said in an email. “Early enrollment data already shows declining coverage, and the combination of the loss of improved premium tax credits and other recent changes in federal policy is making it increasingly difficult to afford health insurance, leaving many families without a realistic alternative.”
Cuts to Medicaid are also leading some insurers to leave states that have expanded eligibility to cover Americans earning 138% or less of the federal poverty guidelines. On Monday, for example, an Arkansas spokesman said Centene – the largest provider of Medicaid managed care in the United States – leaving that state’s Medicaid program.
