Authored by Lawrence Wilson via The Epoch Times,
Obamacare enrollment declined by nearly 3 million in 2026, sparking renewed debate about the affordability of healthcare in America.
National politicians and policy experts disagreed on the reasons for the dip in enrollment, with some saying that it was driven by rising premiums.
Others said the decline was evidence that program integrity measures taken by the Trump administration were successful in rooting out fraud and waste.
The program grew significantly during the declared National Health Emergency from 2021 through 2024, when eligibility verification requirements were relaxed and participants were automatically reenrolled.
Enrollment peaked at 22.1 million last year and dropped to 19.2 million as of February, according to federal data released June 26.
Though that’s still higher than in any year except 2025, some analysts interpreted the decline as a massive loss of coverage resulting from the One Big Beautiful Bill Act of 2025.
“One year later, the Trump administration’s policies are bleeding the revenue of the American tax system and have left millions of Americans without health coverage and food assistance,” Amina Khalique and Natasha Murphy wrote in a June 25 article for Center for American Progress, writing on the anniversary of the bill’s passage.
Others including Brian Blase, president of Paragon Health Institute, say that the changes mostly reverted to pre-pandemic coverage and policy rules, which had been an incentive for fraud.
“Excessive subsidies and zero-premium plans created unusually strong incentives for improper enrollment, while weak verification systems, permissive enrollment pathways, and insufficient oversight allowed those incentives to be exploited at scale,” Blase wrote in a June analysis.
The Trump Administration has focused on program integrity, preventing about 2.9 million enrollees from receiving Obamacare subsidies that they didn’t qualify for, according to a statement from the assistant secretary for Health and Human Services.
The government estimates that 2.6 million fraudulent enrollments remain in the program, down from an estimated high of 5.6 million last year.
Either way, the changes left millions uninsured, according to some experts.
About 9 percent of 2025 Obamacare enrollees became uninsured as of March, according to a survey conducted by health research group KFF.
“While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced steep increases in their premium payments,” Cynthia Cox, a senior vice president at KFF, wrote on social media on June 29.
“Real people lost their health insurance or are now paying more,” Cox said.
The average monthly premium for 2026 is $178, compared to $113 in 2025, according to KFF. However, the 2026 premium is lower than the 2021 premium after adjusting for inflation.
The benchmark silver premium, which is used to set subsidy rates, increased by about 25 percent in 2026, according to KFF.
Democrats seized on the enrollment data to criticize President Donald Trump and Republicans over healthcare affordability.
“Trump and congressional Republicans let healthcare premiums explode and now millions of Americans can’t afford coverage,” Sen. Kirsten Gillibrand (D-N.Y.) wrote on social media on June 29.
“That’s not right,” said Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services, responding to the argument that premium increases have forced people off of the program.
“The reality is we have a lot of fake people on the policies,” Oz told Fox News on June 29.
Oz cited that 40 percent of enrollees never use the policies as proof that many either do not want the coverage, do not realize they have it, or were fraudulently enrolled.
Prior to the introduction of the enhanced subsidies in 2021, Obamacare enrollment had declined for four years.