IRA

16 Million Americans Would Become Uninsured Due to Reconciliation Bill and Loss of Tax Credits; 8.2 Million in Marketplaces Alone

Leaders from State-based Health Insurance Marketplaces, Enrollees, Providers, and Small Business Highlight Potential, Devastating Impacts

(Washington, DC) The Congressional Reconciliation bill and loss of federal tax credits would result in 16 million Americans losing health coverage, including 8.2 million enrolled in Health Insurance Marketplaces. By stripping millions of lives from the Marketplaces, health care will be more expensive, harder to access, create a strain on health care systems, and hurt small businesses.

At a virtual press conference earlier today, leaders from across the country detailed the impacts on access to private health insurance from the Reconciliation bill passed last month by the House of Representatives. Combined with the looming expiration of federal tax credits at the end of the year, these changes would sharply increase the uninsured rate, deeply damage health care delivery, and increase costs in every community across America.

via the Maine Bureau of 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:

A couple of days ago I took a look at the letter sent by the Congressional Budget Office (CBO) to Democratic ranking committee members which broke out the ~16 million Americans expected to lose healthcare coverage via the #MAGAMurderBill passed by House Republicans, assuming they also fail to extend the IRA tax credits beyond the end of 2025.

There was a lot to unpack there, all of it pretty horrible...but I felt one provision in particular was worth its own separate post:

Funding Cost-Sharing Reductions.

Enacting section 44202 would affect the cost-sharing reductions that the ACA requires insurers to offer to eligible people who purchase silver plans through the marketplaces. Those reductions increase the actuarial value—the average share of covered medical expenses paid by the insurer—above the amount in other silver plans, resulting in lower out-of-pocket costs for eligible enrollees. To be eligible for cost-sharing reductions an enrollee’s income must generally fall between 100 percent and 250 percent of the FPL; the subsidy varies with income.

Via the Massachusetts Division of Insurance:

Merged Market Summary for Proposed Rates Effective for 2026

The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2026). This information is subject to change as the rate review process continues.

The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2025.

There are 711,563 consumers enrolled in merged (individual/small group) market plans (data as of December 2024).

The Congressional Budget Office has published several projections about how many people would lose healthcare coverage and/or become uninsured (these aren't the same thing) under various versions of the #OneBigUglyBill Act passed by House Republicans, which is currently beginning its next phase over on the Senate side of the Capitol.

Their most recent projection put the total at around 11.7 million when you include some technical weirdness which I'm a little vague about...plus another 3.8 million if you include their projection from December 2024 regarding the impact of the upgraded ACA subsidies included in the Inflation Reduction Act being allowed to expire at the end of this year. This placed the grand total at around 15.5 million...except they more recently sent a letter to the House Energy & Commerce Committee which bumped this estimate up a bit more, putting the combined total at 15.9 million.

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. 

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.

Hot off the presses via the New York Dept. of Financial Services:

MVP Health Plan, Inc.

Generally, once a year MVP files for a change to the current premium rates on file for their products based on a review of the adequacy of the rate level. Premiums need to be sufficient to cover all medical and pharmacy claims submitted from covered members, cover the administrative cost of operations, Federal and New York State taxes/assessments levied and New York State statutory reserve requirements.

MVP is proposing a premium rate adjustment effective January 1, 2026. Policyholders will be charged the proposed premium rates upon renewal in 2026 pending New York State’s Department of Financial Services review. There are 13,062 policyholders and 19,125 members currently enrolled in Individual MVP Health Plan, Inc. plans. The proposed premium rate adjustment represents an average increase of 8.00%. Premium changes will vary by plan design.

Premium rates are changing due to the following reasons:

via the Office of the Washington Insurance Commissioner:

OLYMPIA, Wash. — Fourteen health insurers have requested an average rate change of 21.2% for Washington state's 2026 Individual Health Insurance Market. Insurers base their requested rate changes on assumptions they make about the services their policyholders will use and the cost to deliver that care. The health plans and proposed rate changes are currently under review by the Office of the Insurance Commissioner.

Wellpoint Washington, Inc. is new to the market and plans to sell in Grays Harbor, King and Spokane counties. 

Congress Urged to Renew Expiring Enhanced Premium Tax Credits and Prevent Unnecessary Increases in Health Care Costs for New Jersey Residents

  • Over 450,000 Get Covered New Jersey enrollees would be impacted by loss of expanded financial help
  • New Jerseyans could lose more than half a billion dollars in federal support and face higher health insurance costs

TRENTON — Warning about significant health insurance premium increases for over 450,000 New Jerseyans, New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman sent a letter to New Jersey’s Congressional delegation strongly urging them to extend the expiring federal enhanced premium tax credits that have enabled hundreds of thousands of New Jersey residents to enroll in quality, affordable health insurance through Get Covered New Jersey, the State’s Official Health Insurance Marketplace.

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