The percentage of ACA enrollees who failed to make payments rose significantly in January, The Wall Street Journal reported April 15.
Four things to know:
1. The Journal’s report is based on analysis by actuarial firm Wakely Consulting Group, which provides the first comprehensive look at the effects of the expiration of the federal ACA enhanced subsidies at the end of 2025. Wakely’s analysis was drawn from insurers representing about 80% of enrollment across 30 states.The analysis does not specify which insurers or states are included.
2. Nationally, about 14% of ACA policyholders in 2026 failed to pay their first monthly bill, according to the report. In a typical year, the rate is in the mid-single-digit range.
3. Failed payments varied by state, according to the report. In some states, the failed payment rate in January was greater than 25%. In other states, nearly everyone who signed up paid their first premium bills. States that used HealthCare.gov rather than their own online marketplaces saw higher average nonpayment rates.
4. Blue Cross Blue Shield of Arizona said that as of late March it had lost more than 30% of members who signed up for 2026 ACA plans. In almost every case it was because the member failed to make payments before the end of the grace period. In 2025, BCBS Arizona lost 2% of its enrollees due to nonpayment by the end of the grace period.
Read the full report here.
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