As 2026 begins, estimates suggest 20% of Ohioans who got health insurance through the Affordable Care Act with subsidies last year are opting out of that coverage this year. And advocates for the ACA said there are signs they’re doing so because without the subsidies, they can’t afford the insurance.
“Currently, 105,000 Ohioans have dropped their coverage,” said Joanne Pickrell with the advocacy group Protect Our Care, referring to early estimates from the Centers for Medicare and Medicaid Services. “That’s compared to last year’s enrollment, and that may get worse.”
A total of 463,086 Ohioans, both new and returning customers, have signed up for coverage through the ACA as of Jan. 15. CMS said last year 583,443 had signed up at this point.
Sudsidies, also known as premium tax credits, were approved to help people pay for health insurance through the ACA when it passed in 2010. In 2021, Congress expanded them as part of the American Rescue Plan Act, but they expired at the end of 2025. The expiration of the subsidies was a key issue in the record 43-day federal government shutdown. That ended with a promise that lawmakers would vote on the issue. But with some Republicans wanting a two-year extension, including Sen. Jon Husted (R-OH). U.S. House Speaker Mike Johnson (R-La.) refused to commit to a vote before the credits expired. The House did approved a three-year extension of the credits earlier this month, when 17 Republicans broke with the party and voted with Democrats. The measure still has to pass the U.S. Senate.
“We do know that about a half million Ohioans were using those extended premium tax credits to make those plans affordable,” said Hannah Halbert, executive director of the progressive-leaning Policy Matters Ohio.
Halbert said it's hard to know how many people who re-upped their insurance with the higher premiums will be able to keep those policies. She said many Ohio families are juggling bills right now to maintain coverage in hopes that Congress will pass an extension of subsidies soon, but she says those families cannot afford to hold on long-term.
Pickrell said she recently had a conversation with a Central Ohio family who lost their subsidy and were deciding what to do.
“And now their monthly premium is more than their mortgage payment and their deductible is $17,000, so as you can imagine, it is pretty stressful for them," Pickrell said.
Pickrell said open enrollment ended Jan. 15 so the estimates being given now will likely change.
