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总结
美国多家媒体报道，奥巴马医改（ACA）市场保险在多数州的年度投保期临近结束之际，因国会未就延长增强型税收抵免/补贴达成协议，部分补贴到期推高保费，导致本季参保人数较上年减少约140万人。部分州投保人数下滑（如密歇根），不少家庭面临月保费上涨、缩减保障或放弃保险，争议将影响医保可及性与后续政策博弈。
正文
1.4 million fewer people enrolled in ACA plans as premiums spike, tax credits expire ABC News ACA enrollment ends today in most states, as tax credit compromise stalls in Congress CBS News Initial Obamacare Enrollment Drops by 1.4 Million as Expiring ACA Subsidies Drive Up Premiums The New York Times 40,000 fewer Michiganders seek Affordable Care Act health insurance Bridge Michigan Most Obamacare enrollment closes leaving Americans with higher bills or less health insurance Reuters
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