Six States Report Higher-Than-Expected ACA Marketplace Attrition After Enhanced Subsidies Expired
State-level enrollment data through April 2026 from Arkansas, Colorado, Maryland, Massachusetts, New Mexico, and New York show significant coverage losses as enrollees canceled plans or stopped paying premiums following the expiration of enhanced ACA subsidies. Georgetown University analysis indicates attrition rates exceed initial federal projections. Congress did not renew the enhanced subsidies that had been in place, resulting in higher premium costs for marketplace enrollees. The coverage losses could affect Medicaid managed care organizations in states with integrated or coordinated care models between marketplace and Medicaid coverage.
MCOs operating in states with marketplace-Medicaid coordination may see increased emergency department utilization and uncompensated care as formerly insured individuals lose coverage, and some newly uninsured individuals may become Medicaid-eligible if income changes trigger eligibility.
Managed Care · Finance
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