Kill the Cliff

Originally posted 12/03/24

Minnesota has around 151,000 residents enrolled in ACA exchange plans, 61% of whom are currently subsidized. I estimate they also have another ~62,000 unsubsidized off-exchange enrollees.

Combined, that's ~213,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 200,000 statewide.

Originally posted 1/02/25

Kansas has around 200,000 residents enrolled in ACA exchange plans, 94% of whom are currently subsidized. I estimate they also have another ~6,000 unsubsidized off-exchange enrollees.

Combined, that's ~206,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be down to more like 192,000 statewide.

Originally posted 12/14/24

Kentucky has around 97,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. I estimate they also have another ~6,800 unsubsidized off-exchange enrollees.

Combined, that's 104,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 97,000 statewide.

Originally posted 12/09/24

Indiana has around 359,000 residents enrolled in ACA exchange plans, 90% of whom are currently subsidized. I estimate they also have another ~6,700 unsubsidized off-exchange enrollees

Combined, that's 5.3% 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 Indiana, however, that would knock the current enrollment down to more like 341,000 statewide.

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.

Originally posted 12/31/24

Hawaii has around 26,000 residents enrolled in ACA exchange plans, 83% of whom are currently subsidized. I estimate they also have perhaps another ~1,700 unsubsidized off-exchange enrollees.

Combined, that's 1.8% 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 Hawaii, however, that would knock the current enrollment down to more like 24,000 statewide.

Originally posted 12/18/24

Idaho has around 117,000 residents enrolled in ACA exchange plans, 86% of whom are currently subsidized. I estimate they also have another ~9,000 unsubsidized off-exchange enrollees, although the actual rate filings (summarized later in this post) put the off-exchange total at a much higher ~47,000.

Combined, that's 6.2 - 8.0% 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 Idaho, however, that would knock the current enrollment down to more like 118,000 statewide.

Originally posted 1/10/2025

Alabama has around 477,000 residents enrolled in ACA exchange plans, 96% of whom are currently subsidized. I estimate they also have perhaps another ~33,000 unsubsidized off-exchange enrollees.

Combined, that's 9.9% 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 Alabama, however, that would knock the current enrollment down to more like 477,000 statewide.

Originally posted 2/2/25

Wyoming has ~46,000 residents enrolled in ACA exchange plans, 95% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees (likely only a few thousand at most). Combined, that's around 8% of their total population.

(Note, however, that the official actuarial rate filings for the 3 carriers offering coverage in the Wyoming individual market only report a combined total of around 39,000 enrollees as of spring 2025, or 6.6% of the total population).

Originally posted 2/05/25

Alaska has around ~28,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. They also have an unknown number of off-exchange enrollees in ACA-compliant individual market policies. Overall, including net attrition, I estimate their total enrollment both on & off exchange to be perhaps ~27,000 or so.