Pennie sign seen at the 2026 Pennsylvania Farm Show, January 8, 2026. (Photo by Whitney Downard/Pennsylvania Capital-Star)
Thousands of Pennsylvanians have left the state’s only Pennie marketplace covered by the Affordable Care Act after monthly premiums skyrocketed as increased federal subsidies expired.
Pennie’s numbers continue to change in the US House of Representatives on Thursday voted to extend benefits for middle-income earners for the next three years. The bill heads to the Senate and, if approved, will need to be signed by President Donald Trump before the subsidies take effect. So far, at least 70,000 Pennsylvanians have left the exchange.
For those who continue to sign up, rising costs mean cutting expenses elsewhere.
Andrew Gehman, who lives in Franklin County, told the Capital-Star that he terminated a $12,000 contract with a retailer after his premium increased from $70 to $240. Gehman, 40, owns and operates 2085 Productions, a Waynesboro-based video production company with projects from Washington, D.C. to Philadelphia.
“This is extremely important. I had to go to the emergency room six, seven years ago when I didn’t have health insurance… and the hospital bill was between $6,000 and $7,000,” Gehman said. “I was out of work at the time, so financial aid was 100% (covered).”
“But the reality is that this is why you need health insurance,” he continued. “Because slip-ups, mistakes and accidents happen.”
We’re just hearing a lot of concern and concern from people about the trade-offs they’re going to have to make financially and the risks they’re going to have to take for their health if they’re no longer insured.
– Principal Penny Devon Trolley
Gehman said he started the company in 2019, initially paying “basically nothing” for Pennie. Last year, his company made $75,000, which doesn’t include expenses.
While he has found a way to balance his checkbook, others are not so lucky. Some reported paying almost $1,800 a month for Pennie coverage.
“You should be able to work full time and be able to afford health insurance,” Gehman said. “… For many people these days, it’s such a high amount that they have to choose between, ‘Well, do I want to pay the mortgage or the health insurance?’ Of course they will get rid of health insurance.”
Recording the falling Pennie
In 2025, 497,000 Pennsylvanians were enrolled in Penn – a record amount. During the enrollment period from November 1, 2024 to January 15, 2025, 90,000 people signed up.
But according to Pennie CEO Devon Trolley, more than halfway through the enrollment window this cycle, overall enrollment is down by 20,000 people, with nearly 1,000 people ending their coverage each day. Between 465,000 and 472,000 Pennsylvanians study at Penn this week. The open recruitment period for this year has been extended until February 1.
“We don’t have a lot of visibility into where people ended up,” Trolley said. “Anecdotally, we hear pretty consistently from our call center that cost has been a major factor this year.”
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Trolley said the most significant premium increases hit people over the age of 55, especially those earning above the increased subsidy limit – about $62,600 for a single person or $84,600 for a two-person family.
“Let’s take a 60-year-old couple for example. In 2025 they were paying about $500 to $600 a month and now in 2026 their bill is $2,000 to $3,000 a month,” Trolley said. “In some cases, we are seeing monthly premiums for this population represent more than 50% of their income.”
Preventive care for this age group can be crucial in identifying chronic disease, and it is basic part services covered by the Affordable Care Act, as detailed by KFF’s health policy group.
“Without health insurance, you won’t treat them early and you won’t manage chronic diseases,” Trolley said. “And by the time they get on Medicare at age 65, the population will be sicker and more expensive (to cover).”
For Scott Cannon, 61, of Luzerne County, insurance is a “must” at his age.
“I can’t not have it, but I know some people younger than me who gamble and don’t drink,” Cannon said. I’m worried about them because if something happened it would be a arduous situation.
Cannon is a videographer whose wife works part-time at a local library. In total, their monthly bill was $83 – which was “very affordable” – and is now $283.
“It’s hard because the prices of everything are going up… I make a lot of films, TV commercials and social media videos for companies, and instead these companies use artificial intelligence,” Cannon said. “It’s getting harder and harder to find a company.”
After using the same landline phone for his business for 30 years, Cannon decided to terminate his contract to make up for the difference in costs.
Although renewing the policy for him and his wife was fairly straightforward, obtaining coverage for their youngest daughter proved to be a challenge.
After turning 19 in November, he is no longer eligible for the Children’s Health Insurance Program, but can get his own policy through Medicaid. However, a paperwork mix-up appears to have closed that path, so the Cannons are considering adding it to their family plan.
“We’re already paying more than we did last year, so now we’re adding my daughter’s insurance on top of that,” Cannon said. “In the meantime, I don’t think my daughter will be covered by insurance.”
In Congress
While the loans are designed to make insurance more affordable, they come with: Price $1 trillion according to the Congressional Budget Office for the federal government. Extending subsidies to those over the threshold makes up for it approximately $35 billion this estimate.
The improved benefit is the latest development – part of a COVID-19 relief package for 2021 enacted under former President Joe Biden and expired at the end of 2025. Grant extension is popular according to a KFF survey, across the country, but Republicans point to rising costs for taxpayers.
The US House of Representatives supports extending health insurance subsidies after a vote forced by Democrats
Votes in the House were mostly along partisan lines, although three Pennsylvania swing district representatives joined Democrats to support the bill: Reps. Brian Fitzpatrick (1st District), Ryan Mackenzie (7th District) and Rob Bresnahan (8th District).
Seven other Republican lawmakers from the Commonwealth voted against the measure.
The U.S. Senate is temporarily working on its own health care package and may not follow the House’s efforts.
Trolley said not knowing where Congress will land complicates Pennie’s job. She added that a “simple extension” would be the quickest solution, but “any further changes would take longer to understand.”
“If Congress takes some action, we will ensure that people have the opportunity to come back and change their minds,” Trolley said. “What that looks like really depends on when exactly the expansion happens and what that expansion looks like.”
