Last year, Republicans and the Trump administration declined to extend Biden-era ACA subsidies that offered relief to 22 million Americans, including hundreds of thousands of Arizonans.
Now, Arizonans are feeling the pinch.
According to data from the Kaiser Family Foundation (KFF), a non-profit organization focusing on health policy, 357,144 Arizonans signed up for Affordable Care Act (ACA) plans for the 2026 year by the Jan. 15 deadline.
But by March, more than 50,000 Arizonans dropped off within a few weeks, according to data from the Arizona Department of Insurance and Financial Institutions, a state agency monitoring insurance and finance institutions.
Some experts had previously warned that higher premiums and deductibles would drive down enrollment rates. Without subsidies, Arizonans saw increased costs for premiums and deductibles, with one one analysis finding that insurance premiums on the Arizona’s ACA marketplace rose nearly 30%.
One retired public school teacher in Scottsdale, Eric Kurland, saw his and his wife’s plan’s coverage rise dramatically, from an original $327 per month in 2024 to the cheapest plan being $2,218 a month in 2026. The couple opted out altogether and began exploring alternative coverage options, instead.
More losses to come
It’s unclear if the 50,000 Arizonans who left ACA plans found other health insurance coverage options or have become uninsured.
Swapna Reddy, a clinical professor at the Arizona State University College of Health Solutions, told the Arizona Republic the numbers speak for themselves.
“The numbers are speaking pretty loudly in the first half of the year, and they not necessarily singing a particularly positive song,” Reddy said. “It’s fairly jarring what has happened in a fairly short period of time.”
A KFF analysis found that ACA enrollment declined in 41 states in 2026. Arizona is one of a handful of states where marketplace plan selections declined the most, including in North Carolina, Ohio, West Virginia, Indiana, and Delaware.
At the same time, the Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid program, is undergoing drastic changes in response to federal policy enacted by the Trump administration.
Last July, Trump signed the One Big Beautiful Bill Act (OBBBA) into law, which introduced new Medicaid restrictions to go into effect by January 2027. The state agency is now making cuts and looking to implement the new and strict work requirements to comply with the federal policies. Between 123,000 and 246,000 Arizonans could lose their coverage as a result.
