State Policy · NH
New Hampshire ACA Marketplace Enrollment Falls 8% After Enhanced Premium Tax Credits Expire
New Hampshire saw 4,868 fewer residents enrolled in ACA Marketplace plans in 2026 compared to 2025, an 8% decline, following the December 2025 expiration of Enhanced Premium Tax Credits. Nationally, enrollment dropped from 21.8 million to 19.2 million. The analysis by KFF used effectuated enrollment data, which reflects both non-enrollment and coverage loss due to non-payment of premiums. The decline coincides with broader federal Medicaid cuts under the One Big Beautiful Bill Act and new state Medicaid premium requirements in New Hampshire, raising concerns among community health providers about access to primary care and emergency department utilization.
Why it mattersThe enrollment decline signals potential Medicaid eligibility churn as individuals losing subsidized Marketplace coverage may seek Medicaid enrollment or become uninsured, affecting state Medicaid budgets and managed care plan member composition.