Missouri ACA enrollment drops nearly 10% as subsidies expire

Enrollment in Affordable Care Act marketplace plans in Missouri fell by nearly 10% this year, according to new data released after the close of the 2025–26 sign-up period in January.

About 365,000 Missourians enrolled in coverage — roughly 42,000 fewer than last year.

Health policy experts point to the expiration of enhanced federal tax credits as a key reason for the decline. The subsidies had helped keep premiums low, and without them, many consumers are now facing significantly higher costs for similar coverage.

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