根据新发布的联邦数据，随着加强版补贴于今年一月到期，美国各州的《平价医疗法案》（ACA）参保人数在过去一年出现显著下降，全国范围内约有 260 万人失去了保险覆盖 [1]。这一数字与去年同期相比呈现明显减少态势 [1]。俄亥俄州和俄克拉荷马州的降幅最为剧烈，两地的参保人数均下降了超过三分之一 [1]。佛罗里达州流失了约 44.3 万名参保人，尽管损失惨重，该州目前仍拥有最多的市场参与者，总数接近 400 万 [1]。新墨西哥州是唯一实现参保人数增长的州，其增幅达到 14%，这得益于该州使用自有资金全额替代联邦补贴的政策安排 [1]。分析人士指出，虽然特朗普政府将部分原因归咎于打击欺诈性注册行为，但保费上涨引发的可负担性问题才是导致参保率下滑的主要原因 [1]。Cynthia Cox 表示，这是首次见到显示 ACA 市场参保人数真正大幅下降的州级数据 [1]。
New federal data indicates that enrollment under the Affordable Care Act (ACA), commonly known as Obamacare, dropped significantly across many states over the past year. Approximately 2.6 million people lost their insurance coverage nationwide compared to the same period last year [1]. This decline coincided with the expiration of enhanced subsidies in January [1].
The most severe drops occurred in Ohio and Oklahoma, where enrollment fell by more than one-third [1]. Florida also saw a substantial decrease, losing approximately 443,000 enrollees; however, it remains the state with the largest number of market participants, nearing four million [1]. In contrast, New Mexico was the only state to see an increase in enrollment, rising by 14% as it utilized state funds to fully replace federal subsidies [1].
While the Trump administration attributed some of these losses to efforts against fraudulent registrations, analysts argue that rising premiums and affordability issues are the primary drivers behind the decline [1]. Cynthia Cox noted that this represents the first time such data has shown a genuine significant drop in ACA market enrollment at the state level [1].