The U.S. Centers for Medicare and Medicaid Services recently published updated data showing how Affordable Care Act enrollments have changed since the expiration of federal subsidies in January that had helped people afford their monthly premiums.
The new numbers reveal that from February 2025 to February 2026, Ohio saw the biggest percentage drop in the country.
Ohio’s ACA rolls dropped from 497,443 people to 336,058 people, a 32.4% decrease. That’s nearly triple the national average and slightly more than Oklahoma’s 32.3% drop. The new data was first reported by the Associated Press.
The Trump administration issued a report last month suggesting the enrollment drop is a result of an anti-fraud crackdown. But industry analysts say it’s due to enrollees concluding they couldn’t afford the ACA plans without the enhanced subsidies. KFF, a healthcare research firm, estimated the subsidy change caused a 58% average increase in out-of-pocket premiums for ACA plans in 2026 and deductibles of about $1,000 more per person – along with double-digit increases in the base premiums.
Analysts previously have said Ohio’s disproportionately large drop could reflect Ohio officials’ past decision to piggyback off the federal marketplace program rather than setting up its own state exchange, as well as the large spike in ACA enrollments Ohio saw after congressional Democrats first approved the enhanced subsidies in 2021. It’s not clear from the federal data whether people who left the ACA are now without health insurance or if they’ve found coverage elsewhere.
Some health insurance providers have announced recently they won’t offer ACA plans in 2027, including Caresource, an Ohio-based company that runs managed Medicaid plans.
Brian O’Rourke, a healthcare policy analyst for the Health Policy Institute of Ohio, said the latest numbers reinforce his previous concerns that the end of the subsidies would result in a large number of people dropping health care coverage.
“Given that the average premium in Ohio [after remaining subsidies] went from $126 to $233 per month, this is not surprising, especially when you also consider all the other cost-of-living pressures that Ohioans are currently facing,” O’Rourke said.
Ohio Association of Health Plans CEO Kelly O’Reilly likewise pointed to the suspended premiums – which Republicans in Congress debated extending before ultimately deciding not to.
“Ohio’s health plans had advocated for the extension of those subsidies last year because we feared many enrollees would drop their coverage because they would no longer be able to afford it. That appears to be happening,” said O’Reilly, whose organization represents insurance providers in Ohio. “This is unfortunate for those enrollees, but also for all Ohioans who will pay higher health insurance costs due to a smaller insurance pool and more uninsured patients seeking emergency care.”
Sherrod Brown breaks with the building trades
Sherrod Brown is campaigning against data centers in his attempt to return to the U.S. Senate – and the pro-labor Democrat is breaking with a major construction union by doing so.
Brown launched an ad this week attacking Republican Sen. Jon Husted for championing the data center industry’s expansion in Ohio during his previous role as lieutenant governor. The ad comes shortly after Brown told Spectrum News he supports ending the lucrative state tax break data centers receive – putting him at odds with the ACT Foundation, a political group that represents the Ohio State Building Trades Council.
The moves are especially notable since some Democrats have been reluctant to campaign too aggressively against data centers in response to lobbying from the building trades, which have endorsed Republicans in some races – including this year’s governor’s race – but which nonetheless remain influential with Democrats.
“I think it’s still a bitter pill for any Democrat to take a stance against a union, but the practical reality is not only have a lot of Ohio unions proven themselves to be fair-weather fans of Democrats, they’ve also proven themselves to not be terribly influential,” said David Niven, a University of Cincinnati political scientist who was a speechwriter for former Democratic Gov. Ted Strickland. “So at some point you can either relentlessly serve their agenda, or you can try to win an election. And I think Sherrod Brown has reached a point where he’s trying to win this election.”
DeWine signs anti-fraud Medicaid bill
Gov. Mike DeWine signed a slew of bills this week. Among them: Senate Bill 315, a measure meant to prevent fraud in the state’s Medicaid program.
SB 315, in part, requires providers of non-emergency medical transportation and nonmedical home care services to check in using GPS technology when providing services. It also requires state officials to use technology meant to detect suspicious billing activity, like when GPS location doesn’t match with billing information, and gives two elected offices – the state auditor and the attorney general’s office – extra legal authority to demand records as part of their fraud investigations.
Republican lawmakers passed SB 315 on a fast track after a national conservative website published a series of reports last month that highlighted a disproportionately high volume of claims in the Columbus area for home health services. The bill went through several revisions – significantly reining in a proposed crackdown on home health services – before eventually drawing buy-in from Democrats.
The bill also requires Ohio to replace the Supplemental Nutrition Assistance Program’s EBT cards with chip-enabled ones as an anti-fraud measure.
A ‘sleeper’ congressional race could be brewing in Ohio
President Donald Trump won Ohio’s 7th Congressional District in 2024 by 11 percentage points. But Democrats are increasingly optimistic they can win the district due to a convergence of several factors.
As Andrew writes, the ingredients include the blue-collar contrast they see between Democratic nominee Brian Poindexter, an Ironworkers union official and city councilman in Brook Park, and incumbent Rep. Max Miller, a former Trump aide who comes from one of Cleveland’s richest families. Miller also is going through a nasty divorce that’s received tabloid coverage – and been referenced by several recent congressional race-rating firms that downgraded the district from being a safe Republican seat to a more competitive one.
Tom Coyne, a Republican former Brook Park mayor, is among those who think Poindexter could win.
Coyne, a vocal Trump supporter and former longtime Democrat, said voters may have soured on Trump over the Iran war and the resulting spike in gas prices. But Coyne also said Poindexter’s alliance with Vermont Sen. Bernie Sanders – who helped Poindexter win the May primary with a last-minute political rally – could backfire.
“If Brian runs an independent campaign on his own, on working man’s values, then I think he has a good chance,” Coyne said. “If he is part of the Bernie Sanders total program there with [New York City Mayor Zohran] Mamdani and company, I would be shocked if Brook Park would support that.”
In the news
Ohio has made $314 million by opening state lands to fracking: Ohio’s new business of leasing about 22,000 acres of its publicly owned lands to the oil and gas industry has grown into a gusher. Read more in Jake’s report.
Ohio college syllabi are going public under Senate Bill 1. Amy Morona reports Ohio college students – or anyone with an internet connection – will soon be able to find out all kinds of information about a class before ever enrolling. Read more.
Left-wing blogger DJ Byrnes, the voice of The Rooster, has rejected a plea deal on a misdemeanor charge of harassing a Republican state senator and is headed to trial. Read more from The Columbus Dispatch’s Laura Bischoff.
