IRA

Originally posted 1/10/25

USE THE DROPDOWN MENU ABOVE TO PICK A STATE.

9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:

Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:

Originally posted 12/23/24

Arkansas has around 166,000 residents enrolled in ACA exchange plans, 92% of whom are currently subsidized. I estimate they also have perhaps another ~11,000 unsubsidized off-exchange enrollees.

Combined, that's 5.7% of their total population.

Assuming the national average 6.6% net enrollment attrition rate thru April reported by the Centers for Medicare & Medicaid Services applies to Arkansas, however, that would knock the current enrollment down to more like 477,000 statewide.

Originally posted 6/04/25

via the Oregon Division of Financial Regulation:

Oregonians continue to have at least five health insurance companies to choose from in every Oregon county as companies file 2026 health insurance rate requests for individual and small group markets

  • In-depth rate review process just beginning, opportunities for public review and input remain through June 20

June 2, 2025

Oregon health insurers have submitted proposed 2026 rates for individual and small group plans, launching a months-long review process that includes public input and meetings.

Five insurers will again offer plans statewide (Moda, Bridgespan, PacificSource, Providence, and Regence), and Kaiser is offering insurance in 11 counties, giving six options to choose from in various areas around the state. 

Originally posted 1/01/25

8/31/25: SEE IMPORTANT UPDATE BELOW!

10/08/25: SEE 2ND IMPORTANT UPDATE BELOW!

New Mexico has around ~70,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~8,000 unsubsidized off-exchange enrollees.

Combined, that's 78,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 70,000 statewide.

Originally posted 1/21/25

California has ~1.98 MILLION residents enrolled in ACA exchange plans, over 88% of whom are currently subsidized. They also have an estimated ~470,000 off-exchange enrollees. Combined, that's over 2.4 million people, or 6.2% of their total population.

Originally posted 12/11/24

Iowa has around 136,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~9,600 unsubsidized off-exchange enrollees.

Combined, that's over 146,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be down to more like 136,000 statewide.

(with apologies to “Weird Al” Yankovic)

Back in July, I warned that my original projections from earlier in the year of how much net ACA enrollee premiums will increase starting in January 2026 in all 50 states +DC if the enhanced premium tax credits are allowed to expire would have to be revised & updated due to two major changes which had taken place since then:

Originally posted 1/08/25

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.

Originally posted 2/4/25

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).

Originally posted 6/03/25

This just in via the Maryland Insurance Administration:

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.

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