APTC

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 12/31/24

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 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 12/07/24

Arizona has around 423,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have perhaps another ~8,000 unsubsidized off-exchange enrollees.

Combined, that's 5.6% 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 Arizona, however, that would knock the current enrollment down to more like 477,000 statewide.

Originally posted 1/06/25

Delaware has ~53,000 residents enrolled in ACA exchange plans, 91% of whom are currently subsidized. They also have an unknown number enrolled in off-exchange plans. Overall, with net attrition, I estimate current total enrollment is down a bit to perhaps 52,000 today.

Originally posted 12/23/24

Connecticut has around ~151,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~7,000 unsubsidized off-exchange enrollees.

Combined, that's 158,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 150,000 statewide.

via Peter Sullivan & Victoria Knight of Axios:

More congressional Republicans are saying they could support a limited extension of enhanced Affordable Care Act subsidies — but only as part of a wider deal and with possible new limits to the assistance.

Why it matters: Democrats are pushing for a clean extension, but the more realistic path, if there's one at all, is a short-term extension that includes conservative health policies.

What they're saying: "How many clean extensions have you seen of late?" said Sen. Thom Tillis, who began pushing for a subsidy extension in the spring. He added that he didn't know what the contours of a deal could look like.

...Changes that could make an extension more palatable for Republicans include limiting the subsidies for higher-income enrollees or requiring that all enrollees pay at least some cost-sharing or premiums.

(with apologies to “Weird Al” Yankovic)

Last winter, I initiated an ambitious project in which I generated graphics to illustrate just how much net ACA premiums are likely to increase starting on January 1st, 2026 (slightly over 5 months from today) assuming the enhanced premium subsidies provided by the Inflation Reduction Act over the past several years are allowed to expire.

This project took several months to complete, as I had to generate both tables and bar graphs for all 50 states (+DC), using 4 different households at multiple income brackets for each. All told, that's over 1,600 different examples.

I made sure to include various caveats for these projections. For instance, each of these examples assumes...

Presented with some comment (but mostly with a link to my state-by-state analysis of how much ACA exchange premiums are likely to skyrocket less than 6 months from now if the IRA subsidies expire):

via Politico, which has acquired the results of a poll conducted by Fabrizio/Ward, which is Donald Trump's own polling firm:

Our survey of voters in the most competitive Congressional Districts shows Republicans have an opportunity to overcome a current generic ballot deficit and take the lead by extending the healthcare premium tax credits for those who purchase health insurance for themselves. Without Congressional action, the tax credit expires this year.

Ever since the MAGA Murder Bill (officially H.R. 1, the so-called "One Big Beautiful Bill Act") was passed by Republicans in the U.S. Senate & House and signed into law by Donald Trump a few days ago, I've seen a growing conventional wisdom taking hold on social media: People keep claiming that either all, "nearly all" or at least "most of" the budget cuts & other gutting of various programs and departments won't actually kick in until after the November 2026 midterms.

Now, don't get me wrong--most of those making these claims are well-intentioned; they're saying this cynically, to underscore how disingenuous Congressional Republicans are by back-loading the pain until the midterms are safely in their rearview mirrors. And, to be fair, much of the damage won't being until well after next November.

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...