Nearly three million fewer people have enrolled in health insurance plans through the Affordable Care Act Marketplace than last year, according to new federal data.

Enrollment in ACA plans so far this year stands at 19.2 million, down nearly three million, or 13 percent, from last year’s high of 22.1.  This is the first time overall marketplace enrollment has declined since 2018.

While many observers credit this decline to the elimination of enhanced subsidies that helped some people pay their insurance premiums, the administration attributes much of the decline to its success in addressing fraudulent applicants and applications.  The reduced numbers also reflect people who signed up for plans but then failed to pay their premiums with the three-month grace period for doing so.

A decline in marketplace enrollment poses a potential challenge for community safety-net hospitals because it means they will almost certainly find themselves caring for greater numbers of insured patients.

Learn more about the decline in ACA enrollments and the possible reasons behind it from the KFF article “ACA Marketplace Enrollment Is Down By 3 Million After Big Jump in Premium Payments.”