New state-by-state data show that Affordable Care Act marketplace enrollment fell in every state but New Mexico, with declines of more than a quarter in nine states and a national effectuation rate that fell below 90 percent for the first time since 2019.
The KFF analysis, drawn from Centers for Medicare and Medicaid Services data, puts February effectuated enrollment at 19.2 million people, down from 21.8 million a year earlier — a 12 percent decline and the first drop in seven years. Effectuated enrollment counts only people who actually paid a premium, which makes it a truer measure of who is covered than sign-up figures.
