Since 2021, federal Enhanced Premium Tax Credits (EPTC) were available in Pennsylvania, totaling $600 million annually, which made coverage more affordable than ever for marketplace enrollees. As a result, Pennie saw enrollment increase by 50% from 2021 to 2025. Pennie enrollment reached its highest point at 496,661 total enrollees in 2025. At the end of 2025, Congress did not reauthorize EPTCs, which resulted in Pennie enrollees seeing costs double on average to keep the same plan in 2026. As a result, the number of people who discontinued their coverage grew. Throughout 2026, Pennie saw an average 9,500 individuals per month leave coverage. Of the 150,000 net enrollment gain Pennie saw between 2021-2025, around 60% of that had already been reversed in the first ten months of 2026 with a 90,000 net enrollment decrease as of 11/1.

Pennie surveyed the population who terminated coverage during open enrollment, and they cited cost as the top reason for leaving. When prices for health insurance go up, those who are younger and tend to be healthier disenroll from coverage first. This loss of healthy risk, in addition to higher utilization of the coverage for those enrolled, has led to another premium increase for 2027. Premiums in Pennsylvania’s individual market will go up by 16% on average this coming plan year. Although tax credits will shield some consumers from the full impact of this increase, those who are unsubsidized will directly feel the rising costs. Additionally, federal policy changes going into effect in 2027 and 2028 will have further impact on the cost of coverage for all enrollees.

Continuing to find ways to make health coverage more affordable and accessible for all eligible Pennsylvanians remains a top priority for Pennie.