New numbers show fewer Ohioans enrolled in Obamacare

New federal data show that fewer Ohioans are enrolled in the federally backed health insurance exchange.

The U.S. Centers for Medicare & Medicaid Services numbers show “effectuated enrollment for a given month” and indicate that Ohio’s numbers spiked in January 2025.

The numbers follow the expiration of enhanced Affordable Care Act subsidies, also known as Obamacare, at the end of last year. According to Axios Columbus, the state has experienced the nation’s largest percentage decline in residents covered by Affordable Care Act plans.

While enrollment has dropped from its high point in January 2025, it remains 78.6% higher than a decade ago. As of February, there were 336,058 Ohioans enrolled in a health insurance exchange. There were 188,127 Ohioans enrolled in January 2016, and enrollment peaked at 529,391 in January 2025.

While some mainstream media outlets have tied the decline to the expiration, a deeper dive shows the enrollment numbers have generally fallen since their high-water mark, though they did increase in the first half of 2025 before decreasing again toward the end of 2025.

Nationwide, the Associated Press reported that roughly 2.6 million fewer Americans had Obamacare plans in February than in the same period in 2025.

“This is the first time we’ve seen state-level data that shows how much ACA marketplace enrollment truly fell,” Cynthia Cox, a vice president and director of the ACA program at the healthcare research nonprofit KFF, told the Associated Press. “It’s in line with our expectations, but it does show a very steep drop in the number of people with ACA coverage.”

However, the numbers might not be what they seem on the surface.

“Due to temporary legislative changes and regulatory approaches that weakened program integrity safeguards, the ACA Exchanges experienced unprecedented enrollment growth from 2021 to 2024, nearly half of which was suspected to be improper, phantom, or fraudulent,” the Assistant Secretary for Planning and Evaluation published in a report last month. “…We estimate 2.6 million improper and phantom enrollments remain, including over 1 million enrollments without a social security number.”

The suggestion of “improper, phantom, or fraudulent” enrollment comes as state officials reckon with allegations of widespread fraud within the state’s social safety net programs, including Medicaid.