The number of people signing up for insurance through the state’s Affordable Care Act marketplace has dropped 16% compared to last year and those nearing retirement age account for the largest share of people abandoning their health coverage.

More than 12,000 people between the ages of 55-64 have terminated insurance coverage purchased through the state’s Pennie insurance marketplace. In all, at least 55,000 individuals and households had terminated their marketplace insurance as of Dec. 17.

The deadline to enroll is Dec. 31.

And the fallout from price spikes could be far worse than it appears. Nearly half of the people who have enrolled have not yet made a payment, suggesting they may ditch the coverage.

“Enhanced premium tax credits have made affordable health coverage a reality for many Pennsylvanians for the first time. Without them, costs will rise sharply, forcing nearly half a million people to choose between their health and their financial security,” Devon Trolley, Pennie’s executive director said in a statement.

Congress did not extend the enhanced premium tax credits, which cover four-person families with income up to $128,600 a year and individuals making up to $62,600 a year. This has caused the cost of marketplace insurance plans to double or more in much of the state.

The state House on Dec. 17 passed a resolution calling on Congress to take action to preserve the premium tax credits.

“During the 2025 open enrollment period for Pennie, nearly 500,000 Pennsylvanians — the most ever — purchased health insurance,” Rep. Anthony Bellmon said in a statement after the vote. Bellmon authored House Resolution 382. “With these federal tax credits set to expire at the end of the year, these individuals could face real consequences, including having to choose between paying for housing, food, utilities or health care.”

Twenty-two Republicans joined all Democrats in voting in favor of the resolution. The same day as the state House vote, three Pennsylvania Republicans in Congress — Reps. Brian Fitzpatrick, Ryan Mackenzie and Rob Bresnahan — joined Democrats to support an unsuccessful effort to force a vote on preserving the Affordable Care Act price breaks.

The marketplace plans are designed to help those who are self-employed, work as independent contractors or work for companies that don’t provide health insurance.

The number of people buying insurance through the Pennie marketplace has increased 50% since 2021. More than 500,000 people bought insurance through the marketplace in 2025, the most ever.

The areas around the state’s biggest cities saw the largest number of enrollees dropping coverage, but the percentage decreases were smaller than in some of the rural counties.

More than 6,000 households terminated their marketplace health insurance in Philadelphia while 4,159 households dropped their insurance in Allegheny County.

Schuylkill County, which had 527 individuals or families drop marketplace insurance coverage — just over 13% of the total enrollees in that county — had the biggest share of people dropping their insurance. In Snyder County, 228 individuals or families have terminated insurance, just under 13% of the total enrolled in the county.

The county with the fewest people in the state saw the smallest drop, both in number and percentage. In Cameron County, just 203 households had been enrolled in marketplace plans and six of them have dropped coverage.

Marketplace terminations by county

— 13% of enrollees terminated — Schuylkill and Snyder counties

— 12% of enrollees terminated — Northampton, Franklin, Lehigh, Tioga, Lancaster, Monroe, Carbon and Greene counties

— 11% of enrollees terminated — Juniata, Bradford, Centre, Clearfield, Wyoming, McKean, Adams, Lebanon and Lackawanna counties

— 10% of enrollees terminated — Berks, York, Mifflin, Philadelphia, Sullivan, Northumberland, Fulton, Cumberland, Beaver, Bedford, Clinton, Montgomery, Pike and Columbia counties

— 9% of enrollees terminated — Mercer, Huntingdon, Luzerne, Erie, Union, Butler, Dauphin, Washington, Perry, Delaware, Cambria, Westmoreland, Lycoming, Warren, Blair, Potter, Allegheny, Chester, Armstrong, Bucks, Susquehanna Lawrence, Crawford and Fayette counties

— 8% of enrollees dropped — Montour, Elk, Somerset, Wayne, Jefferson, Forest, Indiana and Venango counties

— 3% of enrollees dropped — Cameron County.