Back in June I ran an analysis to try and break out just how many Americans are likely to lose healthcare coverage in every Congressional District nationally under the recently-passed MAGA Murder Bill, officially known as H.R.1, the One Big Beautiful Bill.
As I showed at the time, while there's around 65% more people enrolled in Medicaid via ACA expansion in House districts held by Democrats (roughly 12.7 million in blue districts vs. 7.7 million in red districts), there's around 34% more ACA exchange enrollees in red districts (around ~13.9 million vs. ~10.4 million in blue districts).
I then went a step further and broke out the House districts into 10 tiers based on what percent of the vote Donald Trump received last year to take a more granular look and found that, shocker, there's no "winners" here; every district is a loser across the ideological spectrum.
The good news is, the Illinois Insurance Dept. now provides a handy, simple table with the actual average rate changes as well as direct links to the actuarial memos & other filing forms for every carrier, which made it easy for me to plug in the effectuated enrollment & calculate the weighted average rate hikes for every carrier in both the individual and small group markets.
The bad news is, some of the actuarial memos themselves are heavily redacted, meaning I'm unable to see how much of the rate hikes are due to the IRA subsidies expiring, CSR payments being reinstated or Trump's tariffs.
As of this morning I've confirmed final/approved filings across 17 states. Across these state the weighted average year over year increase is 21.5%, down about 1.4 points from the preliminary increase of 23.0%.
I expect final filings for at least a dozen more states to come in over the next week or so, but unless a couple of large states like Texas or Florida have dramatic reductions in their rate increases along the lines of New York or Vermont, I'd still expect the overall national average to and up over 20%.
Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.
In any event, according to the latest report, as of May 2025:
PENNSYLVANIA – August 26, 2025 – Pennie, Pennsylvania’s official health insurance marketplace, in coordination with Health Market Connect LLC (HMC), the newly appointed contractor of Pennie’s Assister Network, is taking a major step forward in connecting the uninsured with affordable health coverage. Pennie and HMC are launching a new network of regional organizations dedicated to providing localized support throughout the Commonwealth.
This innovative and community-centered model is designed to ensure that every Pennsylvanian, regardless of where they live, has access to trusted, in-person assistance when exploring their health coverage options. The appointed regional organizations will be responsible for hiring local Pennie-Certified Assisters who will serve as trusted guides throughout the enrollment process and conducting outreach to the uninsured.
Marketplace enrollees from across the country joined State-based Health Insurance Marketplace leaders and insurance experts at a virtual press conference today to discuss the immediate, real-world impacts of potentially losing their health insurance tax credits.
More than 24 million Americans enrolled in Health Insurance Marketplaces have come to rely on increased insurance affordability, thanks to enhanced premium tax credits (EPTCs) set to expire at the end of 2025. Without Congressional action by September 30, the loss of EPTCs is estimated to cause 4.2 million Americans to lose their health insurance. Marketplace consumers are expected to see an average 75 percent cost increase across states.
From small towns to the nation’s most populous state, enhanced premium tax credits are helping millions of Americans get the financial help they need to get connected to affordable health insurance.
Each year insurers that sell Individual and Small Group plans in Maine's pooled risk market must submit their proposed forms and rates to the Bureau of Insurance, using the System for Electronic Rate and Form Filing (SERFF). Details of the filings submitted to the state since June 10, 2010 can be viewed in the system.
Anthem Health Plans of Maine:
The proposed rates have been developed from 2024 Individual and Small Group ACA combined experience, and the proposed average annual rate change at the Merged Market level is 18.0%.
The proposed annual rate changes by product for Individual range from 17.9% to 20.6%, with rate changes by plan from 10.1% to 30.0%. These ranges are based on the renewing plans, and are consistent with what is reported in the Unified Rate Review Template. Exhibit A shows the rate change for each plan.
Factors that affect the rate changes for all plans include:
Maine has around 64,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~4,500 unsubsidized off-exchange enrollees.
Combined, that's around 70,000 people, although it could be somewhat lower due to net enrollment attrition since January.
For months now I've been shouting from the rooftops about the imminent expiration of the improved federal tax credits for ACA enrollees, repeatedly pointing out that those already paying full price are gonna get hit with average premium hikes of over 23% while most of the 92% of exchange enrollees who currently receive at least some federal assistance will see their net premiums skyrocket by up to 100%, 200% or even 300% or more.
Having helped cause this crisis in the first place both by refusing to push Congressional Republicans to extend the enhanced subsidies as well as by changing the Premium Adjustment Percentage Index formula (PAPI) to make the remaining subsidies even less generous, the Trump Regime has come up with what I'm sure they think of as a brilliant "solution" to the problem.
Back in March I wrote about a proposed rule (really a set of rules) put out by the Trump Regime's Centers for Medicare & Medicaid Services (CMS) which, if implemented, would make major changes to how the Affordable Care Act is administered. This rule was finalized in June, with some provisions kicking in immediately, most starting January 1st and others over the next couple of eyars.
This set of regulatory changes is completely separate from the impending expiration of the improved premium tax credits which I've written so much about; these have to do with the specifics of how the ACA is actually implemented going forward.
A very simple example of this is the length of the annual Open Enrollment Period, which has ranged from as long as 6 months during the very first OEP in 2013-2014 to as short as just 75 days during most of the first Trump Administration.
