As Affordable Care Act enrollment declines, rural Ohioans are being hit hard

As Affordable Care Act enrollment declines, rural Ohioans are being hit hardThis story was originally published in The Daily Yonder, a national news organization covering rural people and places. Since enhanced federal subsidies for Affordable Care Act plans expired in January, Ohio has seen the nation’s steepest decline in Marketplace enrollment. The Buckeye State’s ACA enrollment fell more than 32% between February 2025 and February 2026, according to the Statehouse News Bureau. Nationwide, enrollment in the ACA Marketplace dropped while premiums increased, but this change is happening the most drastically in nonmetropolitan, or rural, counties. In New Mexico, ACA Marketplace enrollment rates increased by 18%, reflecting the state’s health insurance affordability plan.