The end of enhanced federal subsidies has caused a significant drop in Affordable Care Act (ACA) enrollment for the 2026 period.

聯邦加強補貼的結束，導致 2026 年期間《平價醫療法案》（ACA）的投保人數大幅下降。

The end of expanded tax credits, which were first introduced by the American Rescue Plan Act, has caused monthly premiums to rise sharply, with an average expected increase of 75 percent. Consequently, this financial change has led to fewer people signing up for insurance. Data from the Centers for Medicare & Medicaid Services shows that enrollment decreased in 41 states, with North Carolina seeing the biggest drop at about 22 percent. However, a few states, such as New Mexico, still reported growth in enrollment.

由《美國救援計畫法案》首次引入的擴大稅務抵免結束，導致每月保費大幅上升，預計平均增幅達 75%。因此，這一財務變動導致較少的人申請保險。根據聯邦醫療保險和醫療救助服務中心（CMS）的數據，41 個州的投保人數有所下降，其中北卡羅來納州的降幅最大，約為 22%。然而，少數州（如新墨西哥州）仍報告投保人數成長。

Experts emphasize that these cost increases mostly affect self-employed people, small business owners, and those whose incomes are just above the limit for subsidies. For example, a small group representing only 3 percent of users accounted for 27 percent of the total decline. Furthermore, research from the University of Colorado Anschutz School of Medicine suggests that basic 'bronze-level' plans are now too expensive for the average person. There is also a concern about a 'death spiral,' where healthier people leave the system to avoid high costs, which then forces premiums to rise even further for the sickest patients. While the Congressional Budget Office predicted a 25 percent drop, the Commonwealth Fund estimates that up to 5 million people could lose their coverage throughout 2026.

專家強調，這些成本增加主要影響自僱人士、小企業主以及收入略高於補貼上限的人。例如，僅代表 3% 用戶的一個小群體，就佔了總降幅的 27%。此外，科羅拉多大學安舒茨醫學院的研究表明，基礎的「銅級」計劃對於一般人來說現在太貴。目前還有人擔心會出現「死亡螺旋」，即健康的人為了避免高成本而退出系統，進而迫使最危重患者的保費進一步上升。雖然國會預算辦公室預測將下降 25%，但 Commonwealth fund 估計 2026 年全年可能有高達 500 萬人失去醫療保障。

Current data shows that many former ACA participants are now uninsured because federal financial help has ended.

目前的數據顯示，由於聯邦財務援助已經結束，許多之前的 ACA 參與者現在處於沒有保險的狀態。