One year after the fast-moving Eaton and Palisades fires destroyed more than 16,000 structures in the L.A. area, California is drafting the toughest statewide rules in the country for vegetation near homes.
Zone Zero: The idea, called Zone Zero, is to prevent plants and flammable items from igniting during a wildfire, spreading flames to the house and the surrounding neighborhood. In high winds, most homes burn down due to embers, the tiny bits of burning debris carried by the wind. In areas at risk of wildfires, homeowners could be required to clear some or all of the plants within five feet of their house, depending on what regulators decide. Well-maintained trees would still be allowed.
Public pushes back: Homeowners have voiced concerns about losing greenery and shade, as well as the cost of clearing the vegetation. Some say they believe plants and hedges saved their homes by acting as a buffer, though many scientific studies show that vegetation increases the risk a building will burn. The new defensible space rules would affect about 17% of buildings in California. But they could set a much bigger precedent across the West, as more states deal with wildfires growing increasingly destructive as the climate gets hotter.
Read on ... to learn more about the science and politics of Zone Zero.
A typical single-family house is encircled by green, its shrubs and plants sitting just under windows and hugging exterior walls. It's an image that California is trying to get homeowners to rethink as the state's risk of extreme wildfires grows.
One year after the fast-moving Eaton and Palisades Fires destroyed more than 16,000 structures in the L.A. area, California is drafting the toughest statewide rules in the country for vegetation. In areas at risk of wildfires, homeowners would be required to clear some or all of the plants within 5 feet of their house, depending on what regulators decide. Well-maintained trees would still be allowed.
The idea, called Zone Zero, is to prevent plants and flammable items from igniting during a wildfire, spreading flames to the house and the surrounding neighborhood. In high winds, most homes burn down due to embers, the tiny bits of burning debris carried by the wind.
Still, the pushback has been strong, even in the Los Angeles area neighborhoods where so many lost homes. In public meetings, homeowners have voiced concerns about losing greenery and shade, as well as the cost of clearing the vegetation. Some say they believe plants and hedges saved their homes by acting as a buffer, though many scientific studies show that vegetation increases the risk a building will burn.
The new defensible space rules will affect about 17% of buildings in California. But they could set a much bigger precedent across the West, as more states deal with wildfires growing increasingly destructive as the climate gets hotter.
High winds spread burning embers into Altadena during the Eaton Fire, leading to the fire's rapid spread through neighborhoods.
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"How we step up and do this is hard, but I think we have to adapt and change a bit if we're going to try to not keep losing our homes," says Michael Gollner, who runs the Berkeley Fire Research Lab at UC Berkeley.
Hundreds of tiny fires
When the Eaton Fire broke out the evening of Jan. 7, Richard Snyder was at his home in Pasadena, working on a slide presentation about wildfire risk. Snyder had spent more than 30 years in firefighting before retiring and now does wildfire risk consulting. So when he saw the smoke in the nearby foothills, driven by powerful winds, he knew it didn't look good.
"I know where the smoke is going is going to be where the fire is going, and I saw this smoke heading off into Pasadena," Snyder says.
He told his wife to evacuate and started telling neighbors to be ready. Snyder decided to stay. Although the fire itself was still more than a mile away, he knew the biggest danger was the glowing embers being blown into his neighborhood by the wind.
"And then it happened," he recalls. "There was a palm tree that lit off and showered our neighborhood with embers and it started a fence on fire at my neighbor's house. Myself and two other retired firefighters tried to put that fire out with garden hoses, and it wouldn't work. It was too hot and the wind was too strong."
In windy conditions, embers can rapidly spread a fire, landing in dry leaves in a roof gutter, bark mulch on the ground or even being sucked into an attic through a vent. Once that fire gets going, the extreme heat and embers help it spread to neighboring buildings.
"I'm looking over and I'm seeing my St. Augustine grass burning," Snyder says. "Who would have thought that green St. Augustine grass would start burning? There's hundreds of little tiny fires burning in the yards and next to the houses of my neighbors."
Several homes in Snyder's neighborhood were lost. His own survived, but with damage. While he says it was a shock, it wasn't surprising to him. For years, wildfire experts had been finding that houses are vulnerable to wildfires both because of the building materials they're constructed with and when something flammable is next to the house. The concept of Zone Zero focuses on the crucial zone within five feet of a structure.
"We're not going to stop the fires, but we can absolutely keep them from burning our houses down," Snyder says. "But it's a change."
Public meetings get heated
California regulators are creating rules for the "ember-resistant zone" next to houses under state law. The original deadline was 2023, but the effort flagged. After the Los Angeles fires, Gov. Gavin Newsom set a new deadline for the end of 2025. With all the debate, regulators pushed past that deadline and say they expect to keep working through March to gather more feedback.
The proposed rules would prohibit flammable items such as firewood, bark mulch, dead leaves and weeds within five feet of a house. Fences and gates would need to be made of metal or other non-combustible materials in that zone. The rules wouldn't go into effect for existing homes for three years and local fire agencies would have some discretion over tailoring it for their areas.
The sticking point is over green vegetation. Trees would be allowed as long as they're well-maintained, by keeping branches five feet above the roofline, for example. When it comes to plants, regulators are considering several options: only allowing potted plants in Zone Zero, allowing plants under 18 inches, or allowing any well-maintained plants with no dead material.
Steve Hawks of the Insurance Institute for Business & Home Safety inspects a home after the Eaton Fire. Embers caught a pile of flammable material, but the house's fire-resistant siding prevented it from spreading.
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The change isn't being welcomed by some California residents. In September, California's Board of Forestry and Fire Protection held a public hearing in Pasadena to gather feedback on the proposed rules.
"Our community just endured the most destructive residential fire disasters in modern history, yet this board is pushing Zone Zero policies that completely miss the mark," Jessica Rogers of the Pacific Palisades Resident Association said at the hearing. "My home and my neighbors' homes burned because of adjacent structures, not vegetation."
In the hours of public testimony, some residents spoke in support of clearing Zone Zero to prepare for wildfires that will inevitably come again. Other residents pushed back, worried that houses on small lots would lose too much greenery and shade, reducing wildlife habitat. Some raised concerns about the cost, since the new rules wouldn't include funding for landscaping work, though California is developing other programs for that. A few residents noted that in the aftermath of the fires, some plants were still left standing.
"I saw the well-hydrated hedges that I had planted protecting my house, acting as a fire catcher, essentially, because they were upwind," Pacific Palisades resident Martin Hak testified at the hearing.
"We know that not everyone will agree with every decision or aspect of what comes next," Board of Forestry and Fire Protection executive officer Tony Andersen wrote about the Zone Zero rules. "But we do know that many Californians agree that protecting our communities is not a passing fad or a momentary response."
The board also posted its responses to many of the questions raised at the hearings.
Do green plants burn?
"We don't really know how often plants can be 'protective' and provide a buffer for homes," says Max Moritz, wildfire specialist with the University of California Cooperative Extension at UC Santa Barbara.
The destruction in a wildfire can be a patchwork, with some homes and plants left standing directly next to others burned to the ground. In the aftermath, it's difficult to know when vegetation was responsible for spreading fire because the evidence is often completely destroyed.
Ember-driven wildfires can leave a patchwork of destruction behind. In Altadena, some buildings and vegetation were left intact, while others were destroyed
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Moritz is one of the few fire experts who say that green plants may not pose a risk to houses and that more research needs to be done. Greener plants, which hold water in their leaves, are harder to ignite. He agrees that some plants, like highly flammable juniper and cypress, should not be allowed, nor should plants with dead leaves or dry branches.
"The really important aspect to the plants is the dead material," he says. "If most homeowners are just going to let dead material accumulate in Zone Zero anyway, then it makes sense that there shouldn't be any plants in Zone Zero."
Other wildfire experts warn that in the hot, windy conditions of an extreme wildfire, all vegetation poses a potential threat.
"Just because a plant is very moist doesn't mean it's non-flammable," says Gollner of UC Berkeley. "Having a well-watered plant is less of a risk, but it's not no risk."
What makes things burn
Gollner runs a "burn lab" on campus, where his team studies how and why materials burn. There, they place a well-watered shrub inside a special chamber lined with sensors. They ignite a small bit of mulch under the plant. After a few minutes, the flames creep up into the base of the plant.
"You can see, once the flames touch the leaves, they immediately dry out and burn," he says.
Gollner says in a wildfire, if a neighbor's fence or shed is on fire, it can dry out and ignite the vegetation next to a home. If those plants are within Zone Zero, the fire can then reach a neighboring house. Even shrubs and hedges that look healthy on the outside are often dry and bare in the interior. At a recent California Board of Forestry meeting, Gollner's colleagues presented their recent experiments about how green plants can burn.
Other scientific studies show that vegetation is influential in wildfire risk. A team from the Insurance Institute for Business and Home Safety, a non-profit research group funded by the insurance industry, inspected damage at more than 250 homes in the Los Angeles fires. They found when Zone Zero had vegetation in quarter or more of it, the chances that a home was damaged or destroyed were almost 90%.
Michael Gollner watches a burn test in his lab at UC Berkeley. Green plants take longer to ignite, but he says leaves can dry out quickly in hot, dry conditions during a wildfire.
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Gollner and colleagues also looked at several of California's recent wildfires and used computer models to simulate those burns under different conditions. Their study found Zone Zero rules could have reduced structure losses by 17%. Another study looking at the 2018 Camp Fire and the 2017 Thomas Fire found having mostly vegetation within six feet of the walls was a big factor in whether the building was lost. Other studies have also shown the importance of defensible space.
Still, minimizing vegetation alone won't guarantee that homes survive. Wildfire experts say buildings need to be fire-resistant as well, a crucial factor in reducing fire risk. Many older homes have wood roofs, wood siding or single-paned windows, which are much more vulnerable to burning. Gutters need to be clear of dead leaves and attic vents need to be covered in a fine mesh, so embers don't get inside.
Homes built after 2007 in wildfire zones are required to meet California's building codes for fire-resistant materials, but most of the state's housing stock is older than that. Some vulnerabilities can't be changed, like when houses are built close together on smaller lots.
With wildfires, neighborhoods are only as strong as their weakest link. Once a fire starts, it can spread from house to house, so wildfire preparation is far more effective when an entire community fortifies itself — something regulators have cited as a reason for the new vegetation rules.
"It's a change of aesthetic, and it's incredibly difficult because it's people's private property," Gollner says. "But a wildland fire is unique amongst all catastrophes in that what your neighbor does directly affects you. We know that whatever we do, it's got to be across the community."
The chemical tank at the GKN Garden Grove aerospace facility.
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Los Angeles Times
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Topline:
On Monday clean up begins for two tanks of neutralized methyl methacrylate at the center of last month’s chemical incident in Garden Grove.
The backstory: About 50,000 Orange County residents were evacuated for several days after one of the tanks overheated on May 21, generating fears of an explosion or a leak through the Memorial Day weekend.
What's next: The cleanup will be done in phases. This phase wraps Thursday, July 2.
A hazardous materials team will begin working Monday to remove neutralized methyl methacrylate from two of three tanks at the GKN aerospace facility in Garden Grove.
Some 50,000 Orange County residents were evacuated for several days last month after one of the tanks overheated on May 21, causing fears of an explosion or a leak through the Memorial Day weekend.
The clean-up will be done in phases, until Thursday, “with multiple layers of safety protocols and oversight measures in place,” according to a press release from the Orange County Health Care Agency.
Garden Grove chemical cleanup
Updates on the cleanup activities will be posted publicly here, including air monitoring data.
Containers that support temperature control and secure transportation will be used in the operation.
Cleanup was initially scheduled to begin June 4, but was postponed after officials said "needed resources" were unavailable.
Orange County District Attorney Todd Spitzer launched an investigation into the incident last month. The FBI and Environmental Protection Agency also seized evidence at the facility earlier this month.
Methyl methacrylate produces a fruit-like odor, Orange County Health Care Agency said residents may notice the scent during the operation. The agency said levels will remain below thresholds that could pose health risks.
Officials say environmental protection will be in place throughout the week. Air will be continuously monitored through both mobile and fixed equipment at the fence line of the facility and in the community. Air and odor monitoring based on wind conditions will also be done. Work will occur only during the daylight hours until Thursday.
Incarcerated people study to take the G.E.D. exam at San Quentin State Prison on July 26, 2023.
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California prisons are limiting access to programs for incarcerated people as the system manages it overtime budget. The state spends about $18 billion a year on corrections.
Why now: The rollback began earlier this month and will end June 30, according to documents obtained by CalMatters. Corrections spokesperson Terri Hardy described the limitations as a “cost-saving measure.” The department’s overall budget has remained about flat since 2022 around $18 billion a year despite recent cuts that include five prison closures.
The backstory: Lawmakers at budget hearings earlier this year pressed Corrections Secretary Jeff Macomber to tighten spending as the department asked for additional $91 million in ongoing funding to cover unbudgeted personnel costs. The department last month also proposed an additional $100 million in workers compensation.
Read on ... for more on how these cuts will affect programs in the prisons.
The California Department of Corrections and Rehabilitation is restricting access to rehabilitative programming for incarcerated people as it clamps down on overtime spending before the end of its financial year.
Hundreds of rehabilitative programs operate throughout California prisons, including restorative justice, violence prevention, higher education, creative arts expression and entrepreneurial training.
The rollback began earlier this month and will end June 30, according to documents obtained by CalMatters. Corrections spokesperson Terri Hardy described the limitations as a “cost-saving measure.” The department did not respond to a detailed list of questions, including which prisons and programs have been affected.
The department’s overall budget has remained about flat since 2022, around $18 billion a year despite recent cuts that include five prison closures.
Lawmakers at budget hearings earlier this year pressed Corrections Secretary Jeff Macomber to tighten spending as the department asked for additional $91 million in ongoing funding to cover unbudgeted personnel costs. The department last month also proposed an additional $100 million in workers compensation.
Tony Tafoya, who’s been incarcerated since 2012, said he’s never seen anything like this happen before. Tafoya said the scale-back has had the biggest impact on college classes. He’s currently enrolled in Mount Tamalpais College at San Quentin but said his math class has missed out on 12 days of instruction.
“I feel like I’m falling behind,” he said. “There’s a lot of healing that comes from going to school. It provides humanity. It makes me feel like I’m actually seen as a person. I feel like that’s what’s being missed out on.”
Programs at Pleasant Valley State Prison in Coalinga have also been interrupted, including a civic education pilot program. The program, run by the organization Initiate Justice, includes just over a dozen incarcerated people who helped draft legislation to improve social emotional learning in the K-12 school system. Assembly Bill 1851, authored by Democratic Assemblymember Mike Gipson from Gardena, is sailing through the Legislature and scheduled for an upcoming education committee hearing Wednesday.
Antoinette Ratcliffe, executive director of Initiate Justice, said the group “thrives off of active and live discussion, off of meaningful exploration.” The severing of that connection disrupts the learning experience and practical application of the programming, she said.
“We have made it a goal across the Legislature to make rehabilitative programming a priority, so to continue to see disruptions like this feels counter to what we agreed upon as a state,” she said. “It feels like a let down.”
Other advocates have echoed those sentiments. Danica Rodarmel, a criminal justice reform lobbyist, said any disruption in people’s ability to access programming impacts their mental health and well being. The completion of a program or certificate, she said, is often a determining factor in people’s ability to be granted parole.
“Limiting people’s ability to engage in pro-social activities is contradictory to the goals of maintaining safe prisons both for the people who are incarcerated but also for the people who work there,” she said.
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Matthew Mealer holds up his targets at the Busch Shooting Range in Weldon Spring, Mo., in May. Mealer said he's generally skeptical of new vaccines but might consider one for Lyme disease if it proves safe and effective.
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Topline:
Pharmaceutical companies Pfizer and Valneva announced this spring that they plan to seek regulatory approval for a vaccine to protect against Lyme disease. But it's unclear whether this latest stab at a Lyme disease vaccine will get a warmer reception if it's approved, especially in the post-COVID era of vaccine skepticism.
Why it matters: About 476,000 people in the U.S. may be diagnosed and treated for Lyme disease each year, the CDC says. Left untreated, Lyme disease can cause a variety of symptoms, from fevers, chills and headaches to arthritis, shooting pains and inflammation of the brain and spinal cord.
Read on ... to see what rural hunters in Missouri think about the possibility of a vaccine and for their stories of how the disease has affected them personally.
More and more Americans are being exposed to these parasites as climate change expands the range where they can survive. That means more people are also exposed to the bevy of health conditions they can cause, such as Rocky Mountain spotted fever, the alpha-gal-triggered red meat allergy and, most common of all, Lyme disease.
For Lyme disease, there may be some additional protection on the horizon. Pharmaceutical companies Pfizer and Valneva announced this spring that they plan to seek regulatory approval for a vaccine to protect against Lyme disease. A previous vaccine for Lyme became available in the late 1990s but was pulled only three years later due to lawsuits, public fear of side effects and a lack of interest.
It's unclear whether this latest stab at a Lyme disease vaccine will get a warmer reception if it's approved, especially in the post-COVID era of vaccine skepticism.
For a sense of how it might go over with rural populations at high risk of Lyme, KFF Health News spoke with a group of hunters.
Few people spend more time in the woods exposed to ticks. At the same time, as a collective, hunters skew conservative, rural and male, according to a survey from the Theodore Roosevelt Conservation Partnership. And these are identities associated with increased hesitancy about or resistance to vaccines, according to Ashley Kirzinger, associate director for Public Opinion and Survey Research at KFF, a health information nonprofit that includes KFF Health News.
Targets for ticks
Left untreated, Lyme can cause a variety of symptoms, from fevers, chills and headaches to arthritis, shooting pains and inflammation of the brain and spinal cord, according to the Centers for Disease Control and Prevention.
About 476,000 people in the U.S. may be diagnosed and treated for Lyme disease each year, the CDC says. That's at least in part because the range of places where cases have been reported has "expanded significantly" since 1995.
So would hunters get the Lyme vaccine if it became available?
"Given my proclivity for the outdoors, absolutely," said Jess Manganelli, one of seven hunters (and one hiker) who spoke with KFF Health News on a recent Saturday at the Busch Shooting Range in Weldon Spring, Mo., just outside of St. Louis.
Of the eight, Manganelli, who had been hunting turkeys the weekend before, was the most positive about the vaccine. Six others said they would consider it but would want more information about its safety and effectiveness, as well as their risk for contracting the disease.
But Manganelli was the only one who believed she may have previously contracted Lyme disease, although she was never formally diagnosed with it. Two years ago, she experienced muscle weakness, tiredness, fatigue, swelling and headaches after a tick bite, but when she went to urgent care, she was told they didn't test for Lyme.
Nearly all the hunters knew someone who had had Lyme disease — an old roommate, a family member, friends, a former student. Lyme can be difficult to diagnose and to treat and is often misdiagnosed at first. Many of the hunters witnessed their acquaintances navigating those challenges and struggling with sometimes debilitating symptoms.
An illness with lingering effects
That familiarity among the hunters in Missouri was unsurprising to author and conservationist Steven Rinella, host of the hunting show MeatEater.
"I'm a turkey hunter. In talking about turkey hunting, you talk about ticks as much as you talk about turkeys," Rinella said. "Just the nature of turkey hunting puts you into exposure. You're sitting for long periods of time, trying to use vegetation for concealment."
In fact, both Rinella and his older son contracted Lyme disease 13 years ago during a bluegill fishing trip in the Hudson Valley in New York. His son developed Bell's palsy, a sudden paralysis on one side of the face, but recovered quickly after a course of oral antibiotics. Steven Rinella's symptoms, on the other hand, lingered for months, leaving him unable to walk down stairs without a handrail or to ride a bike. He ended up receiving intravenous antibiotic treatments for a month.
"I thought my life had changed," Rinella said, "but I recovered, as far as I know."
That experience is one reason Rinella said he would absolutely consider getting a Lyme vaccine if it proved safe and provided considerable protection against the disease. Unlike with some other diseases, prior infection does not provide permanent immunity, so a person who has had Lyme could still benefit from a vaccine.
Knowledge of similar challenges influenced the thinking of the hunters in Missouri as well.
Jeremy Hollingshead said he may be less inclined to take a vaccine owing to his former roommate's experience with Lyme disease, which is not to say the experience was pleasant. In fact, Hollingshead said he thinks his old pal is still dealing with lingering effects of it 10 years later. But Hollingshead has spent his whole life in the woods, and of hundreds of people he knows who have done the same, he knows of only one of them contracting Lyme.
"I know it was a bad outcome for him," Hollingshead said, but he thinks the odds of getting Lyme himself seem pretty slim.
Meanwhile, Julian Barnes said seeing a relative struggle with Lyme makes him more open to a potential vaccine. It took a long time for doctors to come to that diagnosis, and finding a good treatment has been equally difficult.
"I would say I am vaccine-hesitant, generally speaking," Barnes said. "But Lyme, I've seen the way it affects people in my life. ... I would definitely have to really understand the vaccine, how it works."
An unclear path for a new vaccine
The new, four-dose vaccine candidate technically missed one of the bars set out in trials because not enough participants contracted Lyme. Still, the companies say it's about 75% effective in reducing cases, and they plan to submit it to regulators for approval. A Pfizer spokesperson said there were no updates on their regulatory efforts when contacted by KFF Health News in June.
Health and Human Services Secretary Robert F. Kennedy Jr. was a noted anti-vaccine activist before taking over as head the agency that oversees vaccine approvals, and he's remade it in ways that have prompted some vaccine makers to pull back on development.
But he's also been an advocate on Lyme disease. In May, he announced an initiative to combat Lyme disease. And during his Senate confirmation hearings, he said his family had been deeply affected by Lyme disease and that nobody would work harder than he would to find a vaccine or treatment.
If the vaccine is ultimately approved by the FDA, an endorsement from Kennedy would go a long way, according to KFF's Kirzinger, particularly among supporters of his Make America Healthy Again movement, who tend to be more vaccine-skeptical.
"They trust him as much as they trust their own doctors to tell them what to do with their health and for health information," Kirzinger said. "If he comes out as a strong proponent of this vaccine and says, 'Look what my administration did, and we made this available,' I would imagine there would be less vaccine resistance among that group."
Only one of the hunters who spoke with KFF Health News said they definitely would not be interested in a Lyme vaccine if it became available.
"I kind of hand it off to God and the body he gave me. I'm pretty durable," JP Cummings said. But even though he's not interested in it for himself, he's curious to see what his fellow hunters do as more information comes out.
"Hunters care about the wildlife; hunters care about health," Cummings said. "They love the wildlife, they love their deer, and they love their fellow hunters."
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF.
The federal government released data on how many people dropped coverage in the 29 states that use the HealthCare.gov marketplace for ACA insurance.
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Topline:
Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and, therefore, dropped coverage.
Why now: Prices in the market skyrocketed after President Donald Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.
What's next: People dropping their coverage tend to be healthier people. If too many healthy people drop out of the markets, there's a danger that the markets could enter a "death spiral."
Read on ... for more on the latest insurance market trends.
Far more people than previously known have dropped Affordable Care Act health insurance for 2026, according to data released Friday.
Five million fewer people are currently enrolled in ACA marketplace plans compared to the record high reached last year. More than 1 million fewer people picked a plan for 2026, and then 4 million more either disenrolled or failed to pay their premiums and, therefore, dropped coverage.
Prices in the market skyrocketed after President Donald Trump and Republicans in Congress failed to extend extra financial help for enrollees last year. The Department of Health and Human Services published a report about the data on its website Friday.
The report says 19.2 million people are currently enrolled in ACA insurance now.
The steep drop in enrollment reflects what insurers, administrators and other health policy experts expected earlier this year. After initial sign ups were lower than last year, they predicted the picture would get worse as time went on and people found they could not afford to pay their premiums.
"The main takeaway is that enrollment is down 13% from last year," explains Cynthia Cox, director of KFF's Program on the ACA. "While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced double- or even triple-digit increases in their premium payments with the expiration of enhanced tax credits."
The idea that the growth in enrollment was due to massive fraud is a theory advanced by the Paragon Health Institute, a conservative think tank influential in the Trump administration.
Many health policy experts are skeptical. They say the increase in enrollment during the pandemic is not suspicious. It was a predictable consequence of Congress's investment of billions of federal dollars in making premiums more affordable — the enhanced premium tax credits.
"The marketplace doubled in size during the period when there were enhanced subsidies because the coverage was much more affordable and much more appealing to people," Cox says.
This year's drop in enrollment is also predictable, given that premium costs doubled, on average, from 2025 to 2026. The costs went up after Republican lawmakers let the enhanced premium tax credits expire; Democrats shut down the government in October 2025 trying to negotiate an extension of the credits that would have kept prices low.
"When their costs went up, many of them dropped their coverage," Cox says.
She adds that while fraud is a real problem in the ACA marketplaces, as it is in all insurance markets, she thinks it does not account for all of the drop in enrollment.
Stacey Pogue, senior research fellow at the Georgetown Center on Health Insurance Reforms, agrees.
"I don't see data that point to that conclusion that a 5 million-person drop can be explained by allegations of fraud," she says. "There's lots of evidence pointing to people making decisions based on what they can pay each month."
The higher health insurance costs are tough for consumers in an economy still plagued by overall inflation. As congress let the prices go up, people made tough decisions about family budgets, where to work, whom to marry and more.
It's also a problem for insurance companies, several of which have announced they will not be participating in ACA markets next year, including Cigna.
"If there are fewer customers, then that makes the market less appealing to insurance companies," Cox says.
That's especially true because the people dropping their coverage tend to be healthier people. If too many healthy people drop out of the markets, there's a danger that the markets could enter a "death spiral."
Cox says she's not worried about a death spiral at this point.
"I think there are still enough people buying ACA marketplace coverage and that's going to keep these markets working," she says. "At this point, we don't see any parts of the country that are at risk of having no insurance company. If that were to happen, that would be what a death spiral might look like."
Even so, the premiums for these plans are on track to keep rising, which could continue to pummel consumers navigating high health care costs. Enrollment in the marketplaces may continue to shrink too. According to a recent analysis from Pogue at Georgetown, early insurance rate filings for 2027 show that rates will be going up again next year.