North Carolina saw the largest drop in coverage in the nation after the expiration of enhanced Affordable Care Act tax credits at the end of 2025. according to a new report from Protect Our Care.

The report finds more than 210,000 people got rid of their ACA coverage between 2025 and 2026. Republicans in Congress refused to extend the improved tax credits, putting the cost for insurance out of reach for many. Across the nation, coverage numbers have dropped by more than 1.2 million since 2025.

"This also isn't counting folks who are being forced to reduce their coverage and rely on high-deductible plans that will force them to pay thousands of dollars more in out-of-pocket costs before their coverage even kicks in," said Vaishu Jawahar, director of policy programs with Protect Our Care.

The Protect Our Care report adds that more than 20 million Americans saw their premiums double or triple this year. Nearly 5 million people are expected to lose coverage by the end of the year.

Jawahar said a greater number of people living without insurance impacts everyone.

"Hospitals will have to distribute those bills and distribute those costs," she said, "and then everyone will end up paying higher costs, having higher hospital bills, higher premiums as a result of these losses in coverage."

She said this only adds to the strain created by cuts to Medicaid under the "One Big Beautiful Bill Act" passed last year. More than 700 hospitals are now facing closure or cuts to services, and nearly 340,000 jobs are expected to be lost by the end of the year. Jawahar said that means people will have to travel farther for care and are more likely to face crowded facilities.

"We're seeing maternity wards close, we're seeing hospitals having to convert to emergency only facilities, we're seeing ERs close," she said. "So people are going to have to travel further to get their health care. They might be in worse condition by the time they get it."

Source: Public News Service