This is gonna be one of the stranger references I've made on this site, but bear with me.
Back in 1996 there was an HBO movie called "The Late Shift" which told the story of the Late Night TV show battle between David Letterman and Jay Leno over who would succeed Johnny Carson as host of The Tonight Show. As stupid as this may sound today, this was actually a Really Big Deal in the '90's...one of those absurd pop culture stories which dominated the headlines and the tabloids for several years.
The movie itself was decent, with some interesting casting including Kathy Bates and Treat Williams, but nothing special. The main problem is that the audience is expected to root and feel sympathy for a couple of dudes who were already rich & famous and who would both continue to be rich & famous no matter how the story played out. The stakes weren't exactly the fate of the world, is what I'm saying.
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:
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...
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.
Twelve years ago, the Wall St. Journal ran a story about the impact of the American Taxpayer Relief Act of 2012, a sweeping tax bill signed into law by President Obama which locked in the Bush tax cuts for lower & middle-class households while allowing them to expire on schedule for wealthier Americans:
A compromise measure, the Act gives permanence to the lower rate of much of the Bush tax cuts, while retaining the higher tax rate at upper income levels that became effective on January 1 due to the expiration of the Bush tax cuts. It also establishes caps on tax deductions and credits for those at upper income levels. It does not tackle federal spending levels to a great extent, rather leaving that for further negotiations and legislation. The American Taxpayer Relief Act passed by a wide majority in the Senate, with both Democrats and Republicans supporting it, while most of the House Republicans opposed it.
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.
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:
Company’s HR Manager Really Pushing Infinite-Deductible Health Care Plan
During a meeting with new hires Wednesday to discuss employee benefits, Radian Analytics human resources manager Ellen Schultz is said to have strongly pushed the company’s infinite-deductible health care option.
According to sources in attendance, Schultz described the low-premium, infinite-deductible plan as the simplest and most convenient choice available to employees, and said it works the same whether plan members need to visit their primary care physician, fill a prescription, or be admitted to a hospital, allowing them in each case to pay 100 percent of the incurred medical expenses.
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.
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).