The government stopped giving extra money for health insurance. Now, fewer people have insurance for 2026.

政府停止提供醫療保險的額外補貼。因此，2026 年有較少的人投保。

The cost of monthly insurance is now 75 percent higher. Because of this, 1.2 million people left their plans. In North Carolina, 22 percent of people stopped their insurance.

現在每月保費上升了 75%。因此，有 120 萬人退出了計畫。在北卡羅來納州，有 22% 的人停止投保。

Small business owners and people with low pay cannot pay the new prices. The cheapest plans are now too expensive for many people.

小企業主和低收入人士無法負擔新價格。現在最便宜的計畫對許多人來說也太貴了。

Healthy people are leaving the insurance plans. This is a problem. Now, the insurance companies may raise prices even more for sick people.

健康的人正逐漸退出保險計畫。這是一個問題。現在保險公司可能會針對病患進一步調漲價格。

Many people do not have health insurance now because the government stopped the help.

由於政府停止補助，現在許多人都沒有醫療保險。

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。

The expiration of enhanced federal subsidies has resulted in a significant reduction in Affordable Care Act (ACA) enrollment for the 2026 period.

聯邦強化補貼的到期，導致 2026 年《平價醫療法案》（ACA）的投保人數大幅減少。

The cessation of expanded tax credits, originally implemented via the American Rescue Plan Act, has precipitated a substantial increase in monthly premiums, with an average projected rise of 75 percent. This fiscal shift has led to a contraction in the risk pool, as evidenced by a 1.2 million person decline in marketplace enrollment during the 2026 open enrollment period. Data from the Centers for Medicare & Medicaid Services indicates that 41 states experienced enrollment decreases, with North Carolina exhibiting the most acute decline at approximately 22 percent. Conversely, a minority of states, including New Mexico, reported enrollment growth.

原透過《美國救援計劃法案》實施的擴展稅務抵免停止，導致每月保費大幅上升，預計平均漲幅達 75%。這一財政轉變導致風險池縮減，在 2026 年的開放投保期間，市場投保人數減少了 120 萬人。根據醫療保險和醫療補助服務中心的數據，有 41 個州投保人數下降，其中北卡羅萊納州下降最為嚴重，約 22%。相反，包括新墨西哥州在內的少數州份，投保人數則有所增長。

Stakeholder analysis reveals that the burden of these cost increases falls disproportionately upon self-employed individuals, small business owners, and those with incomes slightly exceeding former subsidy thresholds. For instance, a cohort representing 3 percent of enrollees accounted for 27 percent of the total enrollment decline. Academic research from the University of Colorado Anschutz School of Medicine suggests that without subsidies, bronze-level plans remain financially inaccessible for the average user. Furthermore, the emergence of a 'death spiral' is hypothesized; as healthier individuals exit the risk pool to avoid escalating costs, the remaining pool of high-risk individuals may drive premiums even higher. While the Congressional Budget Office projected a 25 percent shrinkage in enrollment, the Commonwealth Fund estimates a potential loss of up to 5 million covered individuals throughout 2026.

利益相關者分析顯示，成本增加的負擔不成比例地落在自僱人士、小企業主以及收入略高於原補貼門檻的人群身上。例如，僅代表 3% 投保者的群體，便佔了總投保人數下降幅度的 27%。科羅拉多大學安舒茨醫學院的學術研究指出，若無補貼，銅級計劃對一般使用者而言在財務上仍無法負擔。此外，學界假設可能會出現「死亡螺旋」；由於較健康的人士為避免成本攀升而退出風險池，剩餘的高風險人群可能會推高保費。雖然國會預算辦公室預計投保人數將縮減 25%，但 Commonwealth Fund 估計 2026 全年可能會損失高達 500 萬名受保人士。

Current data indicates a widespread trend of uninsured status among former ACA participants due to the termination of federal financial assistance.

目前數據顯示，由於聯邦財政援助終止，原 ACA 參與者中出現了廣泛的未投保趨勢。