Michigan Affordable Care Act marketplace enrollment slumps amid rising costs

July 14, 2026 - 01:57

Michigan saw a sharp decline in Affordable Care Act marketplace enrollment this February, losing roughly 130,000 people from its plans. The drop is part of a broader national trend, as rising premiums and out-of-pocket costs push consumers away from coverage they can no longer afford.

State health officials point to several factors behind the slump. Monthly premiums for mid-level plans have increased by an average of 12 percent compared to last year, while deductibles have also crept higher. Many enrollees, especially those who do not qualify for federal subsidies, have simply stopped paying their premiums. Others have shifted to employer-sponsored insurance or Medicaid, though those options are not available to everyone.

The timing is notable. February is typically a stable month for enrollment after the open enrollment period ends. But this year, insurers reported a higher-than-usual number of policy cancellations for nonpayment. Some consumers say they signed up for plans during the fall but later realized the coverage was too expensive once the bills arrived.

Advocacy groups warn the drop could leave thousands of Michiganders without any health coverage at all. Emergency room visits for preventable conditions may rise as a result. Meanwhile, the state is exploring ways to lower costs, including a proposed reinsurance program that would cap insurer losses on high-cost patients. But that plan would require federal approval and would not take effect until at least 2027.

For now, the numbers paint a clear picture: the ACA marketplace in Michigan is losing ground, and the trend shows no sign of reversing soon.