Medicare Advantage (technically "Medicare Part C" & originally called "Medicare+Choice") is a type of health plan in the United States offered by private companies as part of the original Social Security Act of 1965 that created Medicare. It permits a private insurance option that wraps around traditional Medicare. Medicare Advantage plans attempt to fill some coverage gaps and offer alternative coverage options.
Under Part C, Medicare pays a plan operator a fixed payment for each enrollee. The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).
ACA exchange enrollment has dropped by more than 11% in Montana since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were only down 5.1% vs. OEP 2025...but effectuated enrollment was 7.6% lower year over year in January, rising to 11.4% lower as of February.
The effectuated enrollment numbers have likely continued to drop more since then (the raw numbers aren't that eyebrow-raising since Montana is a small state, population-wise).
Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:
(Washington, DC) – The DC Department of Insurance, Securities and Banking (DISB) has received 181 proposed health insurance plan rates for annual review in advance of open enrollment for plan year 2027. The proposed rates were submitted for DC Health Link, the District’s health insurance marketplace, from CareFirst BlueCross BlueShield, Kaiser Permanente, and UnitedHealthcare.
The proposed rates apply to individuals, families and small businesses for the 2027 plan year. The total number of plans submitted decreased from 194 for the 2026 plan year to 181 for the 2027 plan year. Small group plans decreased from 167 to 157, while individual plans decreased from 27 to 24.
ACA exchangeenrollment has dropped by 10% in South Dakota since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were down7% vs. OEP 2025...but effectuated enrollment was 10.5% lower as of February.
Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:
Initial signups during Open Enrollment were only down about 2% vs. 2025..but effectuated enrollment began to drop immediately and has continued to drop every month since then.
As of June 2026, effectuated enrollment is down 8.4% vs. a year earlier, and is down 7.7% on average for the year so far. That's around 22,000 fewer Coloradans with ACA exchange coverage so far this year:
ACA exchangeenrollment has dropped by 8% in Virginia since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were only down ~5% vs. OEP 2025...but effectuated enrollment was down 6.3% year over year as of January and 8.1% as of February.
That's nearly 30,000 Virgnians who lost healthcare coverage in the first two months of the year.
Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:
WASHINGTON—Vice President JD Vance’s antifraud task force is set to remove hundreds of thousands of enrollments from the Affordable Care Act’s public exchanges, saying those enrollees don’t meet eligibility requirements or don’t exist at all.
...Vance and Dr. Mehmet Oz, the administrator for the Centers for Medicare and Medicaid Services, or CMS, are set to announce they are canceling subsidy payments for allegedly unauthorized and fraudulent enrollments in the ACA, also known as Obamacare, for 760,000 individual accounts, according to administration officials. They say those cancellations would amount to saving an estimated $2.2 billion in taxpayer funds.
Before I begin, it's important to note that ACA exchange enrollment has dropped in Pennsylvania since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year...although thanks to the state implementing fairly robust Premium Alignment pricing, it's not nearly as dramatic a drop-off as in most other states.
Initial signups during Open Enrollment were actually slightly higher than last year...but effectuated enrollment began to drop starting in February and has continued to drop at an increasing rate every month since then. As of July 2026, effectuated enrollment is down more than 10% vs. a year earlier, and it's down nearly 4% on average for the year so far. That's 48,000 fewer Pennsylvanians with ACA exchange coverage as of July:
ACA exchange enrollment has dropped by 11% in Nevada since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were only down ~6% vs. OEP 2025...but effectuated enrollment has gradually shrunk further every month since then and stood at 11.1% lower as of May 2026.
That's over 11,000 Nevadans who have lost coverage so far this year.
Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:
ACA exchange enrollment has dropped by 18% in Delaware since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were already down over 15% vs. OEP 2025...and effectuated enrollment has continued to slip to the point that it was 18% lower in February 2026 than a year earlier.
Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:
