February 09, 2026
Thom Carroll/for PhillyVoice
Pennie said enrollment in ACA health insurance declined in Pennsylvania due to soaring costs. State residents who did buy a marketplace plan increasingly chose the cheapest tier.
Pennsylvania residents who bought health insurance on the state's marketplace dropped their plans in droves, new data reveals. The cause, according to Pennie officials, was the price hike spurred by recently expired federal tax credits.
Those enhanced credits had lowered costs for 92% of Americans enrolled in an Affordable Care Act plan, cutting premiums by more than half. But following the 43-day government shutdown last fall, Congress did not reach an agreement to extend them. Now, states are starting to see the effects.
Roughly 486,000 people bought a Pennie plan during the latest open enrollment period, which ended Jan. 31, but about 85,000 canceled their policies for 2026, the marketplace said. That means roughly 18% of subscribers, or nearly 1 in 5, dropped their health insurance coverage. Termination rates were particularly high among older and rural Pennsylvania residents.
While enrollment was initially on track to outpace the previous year by 11%, it cratered following the credits' expiration. Enrollment was ultimately 2% lower than it had been in 2025, a trend reversal that Pennie attributes to "unprecedented" premium hikes. The price of plans on the state marketplace increased by an average of 102%.
New enrollment was also 12% lower compared with the previous year. Pennsylvania residents who did purchase health insurance through Pennie increasingly chose the cheapest plan available. Roughly 33,000 more people chose coverage from the "bronze" tier, which typically offers lower premiums but much higher out-of-pocket costs than gold or silver plans.
"Pennie has heard from many Pennsylvanians facing the difficult decision to go without health coverage," the marketplace said in a release. "Many have reported that the decision to keep or drop coverage is not a matter of choosing a different plan, but of choosing between health coverage and other necessities like rent, food and utilities."
New Jersey's marketplace has not released updated numbers since its open enrollment ended. But two days before the Jan. 31 deadline, Get Covered NJ reported a 30% decrease in new enrollees and a similar shift toward bronze plans. The health insurance exchange was still on track to finish with a slightly increased consumer base.
Representatives for Get Covered NJ did not immediately clarify their final numbers.
Pennie officials said plan terminations were likely to increase in the ensuing months, placing further strain on the state's health care system. New subscriptions, which offset some of the decline, will be limited now that open enrollment has ended.
"Higher uninsured populations drive up medical bankruptcy and debt, discourage entrepreneurship and small business employment, and increase uncompensated care costs for hospitals and providers," the marketplace said. "These financial pressures weaken the healthcare system as a whole, especially for many rural hospitals that are already operating on thin margins where even small increases in the uninsured rate can threaten their long-term viability.
"On the health side, more uninsured residents mean delayed care, worse health outcomes, and a greater reliance on emergency rooms. When conditions go untreated, Pennsylvanians are more likely to experience preventable complications, permanent disabilities, and a reduced ability to work and live independently."
Follow Kristin & PhillyVoice on Twitter: @kristin_hunt
| @thePhillyVoice
Like us on Facebook: PhillyVoice
Have a news tip? Let us know.
