Pennie, Pennsylvania’s Marketplace Insurance Exchange, has experienced a significant drop in enrollment, with 160,000 Pennsylvanians who had coverage in 2025 choosing not to continue in 2026. This includes 85,000 cancellations or terminations during Open Enrollment and another 75,000 cancellations since February. New enrollees have offset some of these losses, the trend shows a growing number of Pennsylvanian’s leaving the marketplace due to affordability will most likely become uninsured.
The decline is increasing, especially among lower-income individuals, older adults not yet on Medicare, and rural residents. Non-payment of premiums is a major factor, with lapses up 60% from last year and double from two years ago. Since February, Pennie’s total enrollment has fallen by over 40,000, despite starting 2026 with 486,000 enrollees. This will drive many to utilize hospitals for care instead of primary care providers for preventive care.