Pennsylvanians dropping health coverage through Pennie citing higher plan costs as the number one reason.
Since additional federal tax credits ended, enrollment through Pennie has dropped by 10% from its peak. About one in three people who had coverage through Pennie in 2025 are no longer enrolled.
Harrisburg, PA – Pennie, Pennsylvania’s official health insurance marketplace, is continuing to see elevated numbers of enrollees canceling their health coverage for 2026. Pennie concluded the 2026 Open Enrollment Period with 486,000 enrollees as of February 1, and that total number has dropped by over 40,000 in the last four months alone. The increased costs due to federal changes are cited as the primary reason for ending coverage, which can negatively impact Pennsylvania’s health care system and economy as the number of uninsured individuals grows larger.
Consumers consistently cite increased costs as the main reason they are dropping coverage. The cost of health plans through Pennie more than doubled from 2025 to 2026, due to lower federal premium tax credits that decrease the cost of health plan premiums. From 2021 to 2025, Pennsylvanians had higher levels of federal premium tax credits that made coverage more affordable than ever. The increased affordability drove record levels of Pennsylvanians being able to have high quality coverage through Pennie. Enrollment peaked at a record high in 2025 with 497,000 enrollees. The additional federal premium tax credits were not extended by Congress and expired at the end of 2025, creating a jump in the cost of coverage through Pennie.
While some who dropped coverage for 2026 have found other coverage, many have stated that they are now uninsured. Pennie has heard from multiple Pennsylvanians facing the difficult decision to go without health coverage. Many have reported that the decision to keep or drop coverage is not a matter of choosing a different plan, but of choosing between health coverage and other necessities like rent, food, and utilities.
Tens of thousands of Pennie enrollees shifted to health plans with lower monthly costs but thousands of dollars more a year in out-of-pocket costs like copays and deductibles. As affordability challenges continue, more consumers are disenrolling from even the lowest costs plans as they are unable to pay the high premiums. Some have found less expensive health plans outside of Pennie that do not provide full coverage or lack critical consumer protections, leaving these individuals at risk of significant medical debt and unexpected costs when care is not guaranteed to be covered.
Rising uninsured rates strain Pennsylvania’s healthcare system and economy. Higher uninsured populations are associated with increased medical debt, reduced workforce mobility and productivity, and higher levels of uncompensated care for hospitals and providers. These pressures can be particularly challenging for rural hospitals operating on narrow margins. From a health perspective, going without coverage often leads to delayed care, worsening conditions, and greater reliance on emergency services, increasing the likelihood of preventable complications and long-term health impacts. Pennie has heard from many consumers who have stated that the only reason they are healthy enough to keep working is because they can manage their chronic health care conditions; the same individuals are worried about what will happen to them and their families if they cannot afford medical care and become too sick to work.
To learn more and see regional impacts, visit pennie.com/affordability.
Despite these cost increases, Pennie is still the home for the most comprehensive health coverage and the maximum consumer protections available. Some premium tax credits are still available, and four out of five Pennie enrollees qualify for premium tax credits. Pennsylvanians needing coverage can visit pennie.com or call 844-844-8040 to explore affordable options on quality coverage and their eligibility for financial savings.
Currently, Pennsylvanians can only enroll if they have a qualifying life event for a Special Enrollment Period – like losing other coverage or moving to PA. Anyone without a qualifying life event must wait until the next Open Enrollment Period to enroll. Due to federal changes, Pennie’s Open Enrollment 2027 will have new dates, starting on October 15th and ending on December 15th. December 15th will be the final and only deadline for 2027 coverage.
About Pennie
Pennie® is the official health insurance marketplace for the Commonwealth of Pennsylvania, and the only source of financial help to lower the cost of high-quality private health insurance plans. Pennsylvanians without access to other health coverage can find affordable health plans through Pennie that meet different needs and budgets. Eligibility for financial help is based on income, family size, and other factors. Pennie is operated by the Pennsylvania Health Insurance Exchange Authority, established under state law. For more information, visit pennie.com.
###
MEDIA CONTACT:
Kelsey Cameron, kecameron@pa.gov