Obamacare’s Enrollment Figures Deserve A Closer Look

BusinessPolicyObamacare’s Enrollment Figures Deserve A Closer LookBySally Pipes,Contributor.Forbes contributors publish independent expert analyses and insights. Sally Pipes is a scholar and think tank CEO who writes on health care.Follow AuthorJun 15, 2026, 08:00am EDT“Declining enrollment is not necessarily evidence of a failing insurance market,” says health expert Sally Pipes. “It may instead reflect a long-overdue correction to enrollment figures that have become inflated by fraud, abuse, and weak eligibility verification.”AFP via Getty ImagesEnrollment on the Obamacare exchanges is falling for the first time in years. The exchanges launched on January 1, 2014—nearly four years after President Obama signed the Affordable Care Act into law on March 23, 2010.A new analysis from KFF estimates that the number of people enrolled in an exchange plan this year could drop by roughly 5 million following the expiration of more generous pandemic-era premium subsidies at the end of last year.Progressives view that decline as evidence that fewer Americans will have access to affordable coverage. But a new analysis from the Paragon Health Institute suggests another possibility. A substantial share of recent exchange enrollment may never have been legitimate in the first place.According to Paragon, roughly 6.2 million marketplace enrollees this year may be improperly enrolled in the exchanges. Some may not actually qualify for the subsidies they receive. Others may have been enrolled in plans without their knowledge.In other words, declining enrollment is not necessarily evidence of a failing insurance market. It may instead reflect a long-overdue correction to enrollment figures that have become inflated by fraud, abuse and weak eligibility verification.MORE FOR YOUParagon’s analysis focuses on Americans reporting incomes between 100% and 150% of the federal poverty level—between $15,960 and $23,940 for an individual. That is the income range that benefited most from the enh...