2026-05-28T10:04:02.305Z / 路透社
- 概要
- 12个州的数据显示退保人数增加、参保人数下降
- 保费上涨导致退保，影响选民情绪
- 医疗成本与汽油价格并列成为选民最关注的议题
纽约5月28日路透电 —— 据自主销售医保计划的六个州截至4月的数据，因未缴保费而退出或被强制移除奥巴马医改医保计划的美国人较往年更多。
这些退保行为在11月的中期选举前给唐纳德·特朗普总统和共和党带来了政治包袱，而此次选举的核心议题预计将是负担能力。
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肯塔基州和爱达荷州的情况尤为突出。在肯塔基州，退保或被移除医保覆盖的人数是去年同期的三倍；而在爱达荷州，参保人数较去年同期减少15866人的基础上，又进一步缩减了24402人。
相比之下，加利福尼亚州的退保人数仅上升了6%。
约2300万人在2026年报名参保或被自动续期了由巴拉克·奥巴马总统推动的《平价医疗法案》所创建的医保计划，较去年下降5%。这一下降主要源于新冠疫情期间为帮助民众维持医保而设立的额外补贴计划终止。
医疗政策研究机构KFF的数据显示，没有补贴后，保费平均上涨114%，达到每年1905美元。
“消费者正直面这些保费的实际无补贴成本，并选择退出医保市场，”KFF政策分析师马特·麦高说道。
负责监管奥巴马医改并为约30个州运营HealthCare.gov网站的美国医疗保险与医疗补助服务中心（CMS）未回应置评请求。
选民议题
北卡罗来纳大学医学院卫生政策教授乔纳森·奥伯兰德表示，医保负担能力是选民的首要议题，其影响将随着今年的推进而加剧，如同“集结的风暴”。
KFF的民调显示，负担得起的医疗保健仍位居公众担忧榜单之首，与美国与伊朗战争引发的汽油和运输成本飙升并列。
超过四分之三的摇摆派选民表示，医疗成本将影响他们的投票决策以及11月大选时支持哪个政党的候选人。
爱达荷州医保交易所发言人表示，负担能力是该州退保人数增加的主要原因。
奥伯兰德称，到11月决定国会控制权的中期选举举行时，将有更多美国人退出医保覆盖，媒体关注度也会进一步提升。
健康保险咨询公司Wakely Consulting Group分析了占奥巴马医改个人市场约80%的保费支付数据，显示截至3月，奥巴马医改的总参保人数可能下降了17%至26%。
Wakely表示，超过14%的参保者未缴纳1月的保费，这与KFF3月的一项民调结果相符，该民调发现约15%的奥巴马医改参保者未缴纳保费，主要原因是成本上涨。
CMS曾表示将在春季发布关于有多少人已缴纳保费的数据。
各州情况各不相同
路透社联系了20个州和哥伦比亚特区的自主运营医保市场的机构，其中12个州提供了过去几个月的简要数据。
康涅狄格州、马萨诸塞州和新墨西哥州表示，今年年初有数千名消费者要么未缴纳首笔保费，要么因未付款而失去了医保覆盖。
大多数州和联邦政府允许90天或更长的缴费宽限期。
在肯塔基州，1月至4月期间，15067名选择2026年医保计划的民众因未缴保费而失去医保覆盖，而去年同期的退保人数为5034人。
肯塔基州卫生与家庭服务部的一位发言人表示，该州1月的总参保人数也下降了8.5%。
KFF的麦高指出，肯塔基州和爱达荷州还可能因农村地区典型的保险公司数量稀少而受损，这抑制了竞争并推高了价格。肯塔基州的一位发言人表示，该州医保交易所2026年仅有三家保险公司，低于2025年的四家。
麦高称，科罗拉多州等一些州能够提供州级支持，以缓解负担能力问题和退保情况，而爱达荷州和肯塔基州并未这样做。科罗拉多州的参保人数下降了2%，宾夕法尼亚州亦是如此。
马里兰州健康保险交易所执行董事米歇尔·埃伯勒表示，参保人数下降了8%，超过60%的退保者将保费上涨或成本难以承受列为原因。她表示，该州预计今年参保人数将下降15%。
“我们将看到逐月下降，尤其是在汽油价格持续攀升的情况下，”埃伯勒说道。“我们必须弄清楚民众的临界点在哪里。”
由纽约的阿米娜·尼亚斯在纽约、艾哈迈德·阿布勒尼恩在华盛顿报道；卡罗琳·休默和比尔·伯克罗特编辑
我们的标准：汤森路透信托原则。
Americans are dropping out of Obamacare, especially in Kentucky
2026-05-28T10:04:02.305Z / Reuters
- 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.
