APTC

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

I've written countless analyses of how much both gross and net premiums skyrocketed from 2025 to 2026 across different states, different income levels and various other demographics...and last week it was revealed that over 3 million ACA exchange enrollees had already been priced out of the market as of April, with the number almost certain to climb further throughout the rest of 2026.

For months now I've been warning that the initial data published about the 2026 ACA enrollment would likely massively underestimate just how ugly things were in terms of both effectuated enrollment as well as how comprehensive the coverage would be for those who did enroll.

Back in December, when Open Enrollment was still going on, I noted that regardless of what the official number of Americans who selected an exchange plan during Open Enrollment was, the actual number of those who would have effectuated coverage over the course of the year would likely be far lower:

So, what will this graph look like for 2026?

...IF that's what ends up happening, it would look something like the following:

Breaking via Burgess Everett of Semafor:

Sen. Bernie Moreno, R-Ohio, made his final pitch to Senate Democrats on a plan to revive expired health care subsidies on Wednesday, according to a copy of the legislation obtained by Semafor.

The Ohio Republican is pitching a one-year extension of the enhanced premium tax credits that expired at the end of last year with an option to use Health Savings Accounts after 2026. it would also bar “individuals not lawfully present” in the US from receiving benefits under the bill.

...The proposal also includes a minimum $5 monthly payment on subsidized plans; extends open enrollment until March 31; imposes penalties on fraud; requires audits of states’ compliance with the Hyde amendment barring taxpayer funding on abortions; includes cost-sharing reduction payments; and caps the subsidies at 700% of the federal poverty level.

Monday, January 12th, 4:45am, via Jordain Carney of Politico:

[GOP Sen. Bernie Moreno of Ohio] said his goal is to get roughly 35 of the Senate’s 53 GOP senators to support an eventual deal — not just a handful joining Democrats on a “defection vote” — and that he’s keeping the White House and Senate leaders closely apprised of the discussions.

...His involvement is also a sign that a new generation of bipartisan dealmakers might be starting to emerge after some of the Senate’s old hands headed for the exits in recent cycles. Moreno is now in close touch with not only Collins and Shaheen but other Senate pragmatists such as Tim Kaine (D-Va.), Lisa Murkowski (R-Alaska) and Angus King (I-Maine).

...The Senate group’s proposed extension would include new restrictions including a $5 a month minimum premium payment and an income cap set at 700 percent of the federal poverty level. In the second year, the proposal would also give enrollees to take their subsidy as cash in pre-funded health savings accounts — an arrangement favored by Trump.

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