The number of Texans who paid for the first month of their Affordable Care Act coverage dropped 4% this year, the state's first year-over-year decline since 2019, according to a first nationwide glimpse at how coverage through the federal marketplace is shaking out this year.

Texas was one of a handful of states to increase its ACA enrollment at the beginning of the year, a surprising data point in the wake of the expiration of tax credits that had subsidized premium costs for most enrollees.

The Centers for Medicare and Medicaid Services has released new provisional data on those who "effectuated" their coverage, which means enrollees who have activated their coverage, usually by paying their first month's premium in February.