It's been awhile since I've done one of these, but let's go through his entire post point by point, shall we?
Ronald Reagan once quipped that “nothing lasts longer than a temporary government program.”
He could have been talking about the effort to extend — for a second time — former President Joe Biden’s Affordable Care Act-enhanced tax credits, a set of extremely generous federal health insurance subsidies intended to help Americans get through the COVID-19 crisis.
Stop right there: The "extremely generous" subsidies which he refers to are actually far less generous for higher-income enrollees than employer-sponsored insurance tax exclusions.
The District of Columbia has around ~15,000 residents enrolled in ACA exchange plans. Unlike most states where nearly all ACA exchange enrollees are subsidized, in DC only around 28% are due to the District having an unusually high income eligibility threshold for Medicaid (210%).
DC also has a unique requirement that ACA individual market plans can only be sold on their ACA exchange; I'm assuming perhaps 1,000 off-exchange enrollees regardless but officially I believe this should be pretty much zilch. With net attrition since January, however, it looks like the grand total is actually a bit below 14,000 District-wide.
This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2026.
The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open enrollment for plan year 2026 on DC Health Link, the District of Columbia’s health insurance marketplace.
The three insurance companies filed proposed rates for individuals, families and small businesses for the 2026 plan year. Overall, 188 plans were filed, compared to 198 last year. The number of small group plans decreased from 171 to 161, and the number of individual plans remained at 27.
West Virginia has ~67,000 residents enrolled in ACA exchange plans, 97% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most).
I joined Brad Friedman of The Brad Blog yesterday to discuss the ongoing battle over saving democracy & the impending expiration of the enhanced ACA premium tax credits (I show up starting about halfway into the hour-long episode).
You can listen to our discussion via various outlets:
Back in July I posted my analysis of the preliminary 2026 rate filings by the 6 Arkansas insurance carriers participating in the individual market. At the time, they looked like this:
...This letter is formal notice that Aetna Health Inc. (“AHI”) intends to exit from the Individual health insurance market in Virginia effective January 1, 2026. Subject to the Department’s review, we will mail the 180-day notices of discontinuance to covered individuals.
As of May 2025, our records show that AHI has 9,810 subscribers and 13,721 total members in Virginia.
Last week I urged Democrats to demand Congressional Republicans rein in the Trump Regime's out-of-control dictatorial rampage as well as going big on healthcare policy as part of the "government shutdown" battle...but that to the extent that they do make the main focus healthcare policy, at the very least to not settle for simply bumping out the enhanced ACA tax credits by a year or two:
You know I'm a pretty mainstream Democrat. I'm not demanding Medicare for All here. What I am urging on the healthcare front is for three clear demands:
Health Carriers Propose Affordable Care Act Premium Rates for 2026
Anticipated loss of federal enhanced premium tax credits leads to highest individual market rate increases proposed since the start of Maryland’s reinsurance program
BALTIMORE – The Maryland Insurance Administration has received the 2026 proposed premium rates for Affordable Care Act products offered by health and dental carriers in the individual, non-Medigap and small group markets, which impact approximately 502,000 Marylanders.
Neighborhood Health Plan of Rhode Island (if IRA subsidies are extended):
Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 16.3%.
The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 15.0% to 17.5%.
Neighborhood Health Plan of Rhode Island (if IRA subsidies AREN'T extended):
Weighted Average Rate Increase: This represents the average rate increase, including modifications to prior year benefits and other pricing adjustments. The average premium increase to consumers, before reflecting changes in age is expected to be 21.2%.
The range of rate changes, before reflecting changes in age, which consumers will experience, is approximately 20.1% to 22.2%.
Blue Cross Blue Shield of RI (if IRA subsidies are extended):
