On Monday I noted that around 20 state-based ACA exchange websites had launched 2026 Open Enrollment "window shopping," which allows residents to plug in their household information (zip code, ages, income, etc) and browse the various health insurance policies they have to choose from for coverage starting January 1st...as well as whatever federal (and state, in some cases) tax credits they'll be eligible for.
Last month I posted an analysis of total enrollment in ACA health insurance exchange coverage nationally which broke the data out by Congressional District partisan lean as well as according to what percent of the vote Donald Trump received a year ago.
My conclusion? Around 20% more QHP/BHP enrollees live in House districts won by Republicans than those won by Democrats last fall…but there’s still an awful lot of blue district residents who are getting hit hard.
Over 26 million Americans in BOTH red and blue districts & states are going to be screwed in the near future if the enhanced tax credits are allowed to expire & the PAPI change is kept in place, and millions of them will lose healthcare coverage completely.
Today, with Supplemental Nutrition Assistance Program (SNAP) benefits also about to be cut off to over 40 million Americans by Congressional Republicans, I decided to take a similar look at how that breaks out along partisan lines.
North Dakota has around ~43,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. I estimate they also have another ~16,000 unsubsidized off-exchange enrollees.
Wisconsin has around ~293,000 residents enrolled in ACA exchange plans, 98% of whom are currently subsidized. I estimate they also have another ~19,000 unsubsidized off-exchange enrollees.
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).
The average proposed rate increase of 12.6%, effective January 1, 2026 is expected to impact 13,677 members, based on membership as of March 31, 2025. The rate increase varies by plan, ranging between 4.4% and 20.5%. Rate changes vary by plan due to the impact of changes in benefits and rating adjustments to account for the non-funding of Cost Sharing Reduction (CSR) payments.
(unfortunately, CareSource WV's actuarial memo is heavily redacted)
Highmark BCBS WV:
Highmark West Virgina (“Highmark WV”) is requesting an average ACA individual market rate increase of 17.0%, ranging from 15.2% to 23.3%. Products submitted with this filing will have effective dates from January 1, 2026 to December 31, 2026. This rate change is projected to affect 28,179 members.
Historical Financial Experience:
Highmark WV incurred an underwriting gain in its ACA individual market programs in 2024.
(Unfortunately, BCBSND's actuarial memo is heavily redacted, so I don't know their current enrollment. I've had to make an educated guess on that; see below.)
Congressional failure to extend the enhanced premium tax credits will lead to an estimated 225,000 Coloradans seeing an average 101% increase in health insurance premiums
DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), today released the final approved premium information on private health insurance plans for 2026 for the individual market (for people who don’t get coverage from an employer plan). These filings have been reviewed and updated to reflect the passage of HB25B-1006, which blunted some of the premium increases.
