美国人正退出奥巴马医改，肯塔基州情况尤甚

Americans are dropping out of Obamacare, especially in Kentucky

2026-05-28T10:04:02.305Z / Reuters

• Summary

• Data from 12 states show increased terminations, enrollment drops
• Higher premiums drive dropouts, affect voter sentiment
• Health costs remain top of mind for voters, along with gasoline prices

NEW YORK, May 28 (Reuters) – More Americans are dropping out or being kicked off Obamacare health insurance for non-payment than in past years, according to data through April from half a dozen states ​that sell the plans themselves.

The cancellations are posing a political liability for President Donald Trump and the Republican party ahead of November midterm elections expected to turn ‌on affordability.

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Kentucky and Idaho particularly stand out. In Kentucky, three times the number of people canceled or were dropped from their coverage, while in Idaho enrollment shrank by 24,402 compared to a loss of 15,866 members during the same time frame a year earlier.

By comparison, in California cancellations rose 6%.

About 23 million people signed up for or were automatically reenrolled in 2026 health insurance plans created by President Barack Obama’s Affordable Care Act, ​a decline of 5% from last year. The decline was largely due to the end of extra subsidies created during the COVID-19 pandemic to help people keep their coverage.

Without ​subsidies, premiums rose by an average 114% to $1,905 annually, according to data from health policy research group KFF.

“Consumers are being exposed to the ⁠actual unsubsidized cost of these premiums and are choosing to leave the marketplace,” said Matt McGough, a policy analyst at KFF.

The U.S. Centers for Medicare & Medicaid Services, which oversees Obamacare and ​runs HealthCare.gov for about 30 states, did not respond to requests for comment.

VOTER ISSUE

Affordability of health insurance is a top issue for voters and its impact will increase as the year goes ​on, like “a gathering storm,” said Jonathan Oberlander, a professor of health policy at the University of North Carolina School of Medicine.

Polling from KFF shows that affordable healthcare remains atop the list of public worries, tied with concerns over surging gasoline and transportation costs stemming from the U.S.-Israeli war with Iran.

More than three-quarters of independent voters being courted by both parties say healthcare costs will affect their decision to vote and which party’s candidate they ​support in November.

An Idaho health exchange spokesperson said affordability was the main reason for the increase in disenrollments there.

By the time November’s midterm elections that will decide control of Congress roll ​around, more Americans will have dropped coverage and media attention will have grown, Oberlander said.

Total Obamacare enrollment likely fell between 17% and 26% through March, according to Wakely Consulting Group, a health insurance consulting firm ‌that analyzed premium ⁠payment data representing about 80% of the Obamacare individual market.

Wakely said over 14% of enrollees did not pay their January premium, in line with a March KFF survey that found about 15% of Obamacare enrollees had not paid their premiums, largely due to higher costs.

CMS had said it would release data on how many people have paid their premiums in the spring.

SITUATION VARIES BY STATE

Of 20 states and the District of Columbia that run their own marketplaces and were contacted by Reuters, 12 provided a snapshot view of the past several months.

Connecticut, Massachusetts and New Mexico ​said thousands of consumers either failed to pay ​their first premium or lost coverage in ⁠the early months of the year due to missed payments.

Most states and the federal government allow a grace period of 90 days or more for non-payment.

In Kentucky, between January and April, 15,067 people who selected 2026 plans had lost coverage due to non-payment, up from 5,034 disenrollments for ​the same period last year.

The state also saw an 8.5% decrease in overall enrollment in January, a spokesperson for Kentucky’s Cabinet for ​Health and Family Services said.

Kentucky ⁠and Idaho may also have been hurt by the low number of insurers typical of rural locales, which dampens competition and raises prices, KFF’s McGough said. A Kentucky spokesperson said the state exchange now has three insurers in 2026, down from four in 2025.

Some states, like Colorado, were able to provide state-based support that helped ease affordability and terminations, said McGough, while Idaho and Kentucky did not. ⁠Colorado had a ​2% drop in enrollment, as did Pennsylvania.

Michele Eberle, executive director at Maryland’s Health Benefit Exchange, said enrollment has fallen ​by 8% and that over 60% of people who disenrolled cited increased or unmanageable costs. The state expects to see enrollment decline 15% this year, she said.

“We’re going to see month-over-month declines, especially with gas prices that are continuing ​to climb,” said Eberle. “We have to see where the breaking point is for people.”

Reporting by Amina Niasse in New York and Ahmed Aboulenein in Washington; editing by Caroline Humer and Bill Berkrot

Our Standards: The Thomson Reuters Trust Principles.