Obamacare Enrollments Drop Across The Industry

Across the health insurance industry, the end of enhanced tax credits is triggering an exodus of health plan members who either can no longer afford coverage or who are buying lower-priced “bronze” plans that carry high deductibles, industry analysts and companies have said.

Earlier this week, Centene, a much bigger player in Obamacare, said such enrollment tumbled by 2 million enrollees to 3.58 million at the end of the first quarter compared to 5.54 million at the end of last year and 5.62 million in the year ago quarter. UnitedHealth Group’s UnitedHealthcare last week said its Obamacare enrollment was down as well, falling to 1.4 million from 1.7 million last year. And a year ago, CVS Health announced plans to exit the individual health insurance business, leaving about 1 million Aetna members in 17 states looking for new coverage for this year.

The big dip in enrollment and health insurer exits are what Democrats in Congress and health insurance industry analysts said would happen after Republicans in Congress and the Donald Trump White House wouldn’t agree to extend enhanced tax credits for buyers of Obamacare. A KFF analysis last fall said middle income Americans “as well as those with low incomes” will see “major out-of-pocket premium increases" if tax credits aren’t extended. And they are with customers reporting a doubling and even tripling of premiums for this year.

The subsidies, or tax credits, made health insurance premiums more affordable for individuals and were enhanced by the Biden administration and the Democratic-controlled Congress, which passed the Inflation Reduction Act of 2022, allowing more Americans to buy coverage. The enhanced subsidies helped enrollment in Obamacare eclipse a record 24 million Americans and drove its popularity to all-time highs.

The Trump administration, via the Centers for Medicare & Medicaid Services, said in late January that 23 million consumers “have signed up for 2026 individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period on November 1, 2025.”

Those numbers, however, include people who signed up or renewed coverage and not those who ended up paying their first month’s premium, industry analysts have said. As insurers disclose falling enrollment or exits, it’s become clear that an additional 1 million+ enrollees (beyond what the Trump administration disclosed) are dropping coverage or can no longer afford it.

Cigna’s Post-Obamacare Plans

For Cigna, the move means the company going forward will be largely focused on providing health insurance coverage and pharmacy benefits in the commercial and employer sector.

Cigna doesn’t administer Medicaid coverage for poor Americans and last year sold its Medicare health insurance plans for older adults to Health Care Service Corp., an operator of Blue Cross and Blue Shield plans in five states.

Cigna reported net income of $1.65 billion, or $6.26 per share in the first quarter ended March 31, compared to $1.3 billion, or $4.85 per share in the year-ago quarter. Revenues rose to $68.5 billion compared to $65.5 billion in the-year ago period driven by the company’s Evernorth health services business, which includes the Express Scripts pharmacy benefit management company.

“Total revenues for first quarter 2026 increased 5% relative to first quarter 2025, primarily driven by growth in Evernorth Health Services, partially offset by the impact of the (Health Care Services Corp) transaction,” Cigna said in Thursday’s report.