Healthcare policy data, analysis & snark.| ACA Signups
Originally posted 7/17/25 Well, the Colorado Dept. of Regulatory Agencies isn't mincing words: Chaos from Congressional Republicans Leads to Average Premium Increases of Over 28% for 2026 Average increases as high as 38% have been requested for the Western Slope, and insurance companies estimate nearly 100,000 Coloradans will lose their health insurance coverage DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) released the preliminary inf...| ACA Signups
Wed, 10/29/2025 - 4:18pm You may have seen this jaw-dropping nonsense yesterday, but if you didn't, here it is again: Reporter: Unless ACA subsidies are extended, the average plan will increase by somewhere around 115% (CMS Director) Dr. Oz: Where'd you get that number? Reporter: The Kaiser Family Foundation Dr. Oz:They retracted that. Here's the truth. The average American who's on ACA is gonna pay $13 more than this year. That's not a big issue. (sigh) where to begin... Well, for starters, ...| ACA Signups
Wed, 10/29/2025 - 10:23am 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. This morning, the number of states with live window shopp...| ACA Signups
Tue, 10/28/2025 - 9:05pm 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. O...| ACA Signups
Tue, 10/28/2025 - 2:59pm Originally posted 12/21/24 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. Combined, that's ~59,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 55,000 statewide. In early 2021, Congressional Democrats & President Biden passed th...| ACA Signups
Tue, 10/28/2025 - 2:33pm Originally posted 12/16/25 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. Combined, that's ~333,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 311,000 statewide. In early 2021, Congressional Democrats & President Biden passed th...| ACA Signups
Tue, 10/28/2025 - 10:15am Originally posted 2/4/25 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). In early 2021, Congressional Democrats & President Biden passed the American Rescue Plan Act (ARPA), which dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sli...| ACA Signups
Tue, 10/28/2025 - 10:10am Originally posted 8/11/25 SCROLL DOWN FOR UPDATES Overall preliminary rate changes via the SERFF database, Wisconsin Insurance Dept. and/or the federal Rate Review database. Aspirus Arise Health Plan of WI 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 c...| ACA Signups
Tue, 10/28/2025 - 10:08am Originally posted 8/08/25 SCROLL DOWN FOR UPDATES Overall preliminary rate changes via the SERFF database, West Virginia Insurance Dept. and/or the federal Rate Review database. CareSource WV: (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 effe...| ACA Signups
Tue, 10/28/2025 - 10:00am Originally posted 8/08/25 SCROLL DOWN FOR UPDATES Overall preliminary rate changes via the SERFF database, North Dakota Insurance Dept. and/or the federal Rate Review database. Blue Cross Blue Shield of ND: (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.) Medica Health Plans: Medica Health Plans (MHP) is requesting a rate change for its Affordable Care Act (A...| ACA Signups
Welp. From the Colorado Dept. of Regulatory Agencies: 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...| ACA Signups
Originally posted 1/10/25 USE THE DROPDOWN MENU ABOVE TO PICK A STATE. 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 versio...| ACA Signups
Wed, 10/15/2025 - 3:58pm Originally posted 8/04/25 10/15/25: Scroll down for FINAL rate filings via the Pennsylvania Insurance Dept: Pennsylvanians can submit comments on rate requests and filings through September 2 Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that the 2026 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available. On average, all Pennsylvania health insure...| ACA Signups
Wed, 10/15/2025 - 2:36pm Last week I noted that six states have launched window shopping for the 2026 ACA Open Enrollment Period (OEP), allowing residents of the following states to plug their household information into their states ACA exchange website to see just how much their net health insurance premiums are going to increase starting January 1st, 2026: Georgia (Georgia Access) Idaho (Your Health Idaho) Note: (Idaho also started letting eligible residents actually enroll starting on 10/1...| ACA Signups
Wed, 10/15/2025 - 2:11pm Originally posted 1/29/25 Pennsylvania has around ~496,000 residents enrolled in ACA exchange plans, 87% of whom are currently subsidized. I estimate they also have another ~103,000 unsubsidized off-exchange enrollees. Combined, that's 600,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 560,000 statewide. In early 2021, Congressional Democrats & President Biden passed the...| ACA Signups
Wed, 10/15/2025 - 12:17pm 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 ...| ACA Signups
Mon, 10/13/2025 - 8:06pm Two years ago the Massachusetts Health Connector sent out the following memo: Pilot expansion of ConnectorCare reshapes affordability and plan options through the Health Connector This historic expansion allows for more access to health insurance plan choices that are both affordable and better suited to meeting an individual’s health needs BOSTON – Today, the Massachusetts Health Connector Board of Directors approved regulatory changes that will expand access to ...| ACA Signups
Mon, 10/13/2025 - 12:34pm As anyone not under a rock for the past few months knows by now, the improved federal Affordable Care Act tax credits which were put into place by President Biden and Congressional Democrats starting in 2021 are currently scheduled to expire at the end of December, just 2 1/2 months from now. If this happens, the consequences for ~24 million Americans will be devastating, with average health insurance premiums more than doubling and millions being priced completely o...| ACA Signups
Fri, 10/10/2025 - 12:12pm Originally posted 8/7/25 SCROLL DOWN FOR IMPORTANT UPDATES. Overall preliminary rate changes via federal Rate Review database. Antidote Health Plan of AZ: (Unfortunately, no rate justification summary is available, and the full actuarial memo is heavily redacted. Policy enrollees are estimated based on marketwide estimated enrollment; see below.) Banner/Aetna CVS: (Dropping out of the individual market for 2026.) I am writing to notify the Department that Banner Heal...| ACA Signups
Thu, 10/09/2025 - 4:40pm Originally posted 7/18/25 I still have the preliminary 2026 rate filings to analyze for about 10 more states, but I'm taking a break to go back and revisit ARKANSAS. Back on July 18th, I posted my original analysis of ACA-compliant individual & small group market filings for Arkansas insurance carriers. At the time, I found that the weighted average increases being requested for individual market policies averaged a disturbingly high 26.2%. Here's what the breakout lo...| ACA Signups
Originally posted 12/23/24 Arkansas has around 166,000 residents enrolled in ACA exchange plans, 92% of whom are currently subsidized. I estimate they also have perhaps another ~11,000 unsubsidized off-exchange enrollees. Combined, that's 5.7% 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 Arkansas, however, that would knock the current enrollment down to more like 477,0...| ACA Signups
Sun, 10/05/2025 - 2:18pm Originally posted 1/21/25 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. In early 2021, Congressional Democrats & President Biden passed the American Rescue Plan Act (ARPA), which dramatically expanded & enhanced the original premium subsidy formula of the Affordable...| ACA Signups
Via NBC News: A Washington Post poll conducted on Oct. 1, the first day of the shutdown, found that 47% of U.S. adults blame Trump and Republicans in Congress, while 30% blame Democrats and 23% said they're not sure. The survey found that independents blamed Trump and Republicans over Democrats by a wide margin of 50% to 22%. And one-third of Republicans were either unsure who to blame (25%) or blamed their party (8%). While I'm glad to see that far more people are rightly blaming Trump & Con...| ACA Signups
Originally posted 7/18/25 via the District of Columbia Department of Insurance, Securities and Banking: This page contains proposed health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2026. The District of Columbia Department of Insurance, Securities and Banking (DISB) received 188 proposed health insurance plan rates for review from CareFirst BlueCross BlueShield, Kaiser Permanente and United Healthcare in advance of open ...| ACA Signups
Originally posted on 8/10/25 Overall preliminary rate changes via the SERFF database, Virginia Bureau of Insurance and/or the federal Rate Review database. Aetna Health: (Aetna/CVS is dropping out of the entire individual market nationally in response to Congressional Republicans allowing the upgraded ACA subsidies to expire): ...This letter is formal notice that Aetna Health Inc. (“AHI”) intends to exit from the Individual health insurance market in Virginia effective January 1, 2026. Su...| ACA Signups
Last week I urged Democrats to demand Congressional Republicans rein in the Trump Regime's out-of-control dictatorial rampage as well as going big on healthcare policy as part of the "government shutdown" battle...but that to the extent that they do make the main focus healthcare policy, at the very least to not settle for simply bumping out the enhanced ACA tax credits by a year or two: You know I'm a pretty mainstream Democrat. I'm not demanding Medicare for All here. What I am urging on th...| ACA Signups
With the ongoing budget battle approaching the Sept. 30th federal government shut down deadline, U.S. Senator Patty Murray (D-WA) and U.S. Representative Rosa DeLauro (D-CT-03) have formally introduced a bicameral Continuing Resolution bill to fund the government for an extra month to buy more time to negotiate and avoid a shutdown by the Republican-controlled federal government: Today, Senator Patty Murray (D-WA), Senate Appropriations Committee Vice Chair, and Congresswoman Rosa DeLauro (D-...| ACA Signups
With the ongoing budget battle approaching the Sept. 30th federal government shut down deadline, U.S. Senator Patty Murray (D-WA) and U.S. Representative Rosa DeLauro (D-CT-03) have formally introduced a bicameral Continuing Resolution bill to fund the government for an extra month to buy more time to negotiate and avoid a shutdown by the Republican-controlled federal government: ashington, D.C. — Today, Senator Patty Murray (D-WA), Senate Appropriations Committee Vice Chair, and Congresswo...| ACA Signups
Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease. Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need. I really only need three pieces o...| ACA Signups
(sigh) So, moments ago I received the following press release from the Centers for Medicare & Medicaid Services (CMS): Today, the Centers for Medicare & Medicaid Services (CMS) unveiled details on how states can apply to receive funding from the $50 billion Rural Health Transformation Program created under the Working Families Tax Cuts Act to strengthen health care across rural America. This unprecedented investment is designed to empower states to transform the existing rural health care inf...| ACA Signups
originally posted 6/7/25 via the Connecticut Insurance Dept: The Connecticut Insurance Department has posted the initial proposed health insurance rate filings for the 2026 individual and small group markets. There are 8 filings made by 7 health insurers for plans that currently cover approximately 224,000 people (158,000 individual and 66,000 small group). Anthem has filed rates for both individual and small group plans that will be marketed through Access Health CT, the state-sponsored heal...| ACA Signups
For months now I've been shouting from the rooftops about the imminent expiration of the improved federal tax credits for ACA enrollees, repeatedly pointing out that those already paying full price are gonna get hit with average premium hikes of over 23% while most of the 92% of exchange enrollees who currently receive at least some federal assistance will see their net premiums skyrocket by up to 100%, 200% or even 300% or more. Having helped cause this crisis in the first place both by refu...| ACA Signups
It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier. In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA al...| ACA Signups
Not that this should surprise anyone, but it's good to have the Congressional Budget Office (CBO) formally chime in: Re: The Effects of Not Extending the Expanded Premium Tax Credits for the Number of Uninsured People and the Growth in Premiums Dear Chairman Wyden, Ranking Member Neal, Senator Shaheen, and Congresswoman Underwood: You have asked the Congressional Budget Office to discuss the effects on health insurance coverage and premiums that will result from not extending—either for one...| ACA Signups
As I noted in yesterday's analysis of the semi-final 2023 Open Enrollment Period report released by the Centers for Medicare & Medicaid Services, one of the most striking data points we're seeing this year is a significant drop in year over year on-exchange enrollment across a number of states operating their own ACA exchanges...even as enrollment continues to surge across states hosted on the federal exchange (HealthCare.Gov). Overall, QHP enrollment in HC.gov states (Federally Facilitated M...| ACA Signups