Enhanced premium tax credits have expired, and the exchange coverage those credits helped pay for is starting to disappear. For many patients, the plan they had last year is no longer an option. 

Providers are already feeling this shift. Several large, publicly traded health systems reported financial hits in the second quarter, and one industry estimate puts the potential revenue loss for hospitals at $68.6 billion over 2026 and 2027. Patients haven’t gone anywhere, though. They’re still walking up to registration desks and into EDs every day, still needing care, just without a payer behind them. 

For providers, a share of that lost revenue is recoverable. It comes down to identifying the patients who still qualify for Medicaid or other assistance, connecting with them before care begins, and doing it at a scale that manual work can’t match. 

On paper, this year looks steady, with 23.1 million people enrolling in exchange plans during the Open Enrollment Period, which is near last year’s record-breaking total. However, sign-ups fell by more than one million from the year before, making it the sharpest annual decline since the marketplaces first opened. 

3 million in 2025. The gap between who signed up for coverage and who can afford to continue it can provide a clearer picture of how many people are actually losing coverage.

Source link