How the health insurance industry is adapting to people dropping coverage.

From Marketplace in Washington, I'm Kimberly Adams. More than a million people dropped their

Affordable Care Act coverage this year after Congress let those enhanced pandemic-era subsidies expire.

That number is likely to rise significantly as the year goes on because many people who did

sign up for a plan have not been paying their premiums. And for the first time in years, the number of

insurers offering ACA plans has dropped too. That's according to a new analysis from the health

policy nonprofit KFF. Marketplaces Samantha Fields has more.

After Congress and President Joe Biden approved the enhanced subsidies in 2021,

the number of people with ACA insurance more than doubled in just four years.

At the same time,

There was a dramatic increase in the number of insurers looking to offer health insurance. Vivian Ho at

Rice University says that's because there was a lot of money to be made. But now with the enhanced

subsidies gone, the opposite is happening. People are dropping out and so are insurers.

One would expect in any market, if there's not as much profit to me made, there's going to be fewer suppliers

of the service. Your standard supply and demand. Cynthia Cox at KFF says the issue for companies like

Etna, which pulled out this year, and Cigna, which is leaving next year, isn't just the number of people

dropping plans. Insurers are also concerned that it's healthier people who are disproportionately

dropping that coverage. And sicker people are more expensive to insure. There are still plenty of

companies offering marketplace plans. Right now, I think most people are still going to have enough

choice of insurers as long as we don't see a lot of further exits.

But there might be more parts of the country that do only have one insurer or two insurers to

choose from. And Cox says less competition could mean higher premiums. I'm Samantha Fields for Marketplace.

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