My colleague @claireheyison.bsky.social unpacks a new analysis showing that marketplace enrollees are paying more and getting less following the expiration of PTC enhancements and implementation of parts of the republican megabill.
I was out last week. Maybe you were, too? ICYMI, great recap from my colleague @nicolerapfogel.bsky.social of what we learned from the recent CMS #ACA marketplace open enrollment data published the week before last. 👇
#ACA marketplace signups are down, and many people are paying higher costs and getting skimpier coverage, according to new federal data. A major reason: Republicans in Congress and the Trump Administration let premium tax credit enhancements expire. www.cms.gov/files/docume...
Since the ACA was enacted, tens of millions of people have gained coverage through the marketplaces. Instead of building on this progress, federal policy changes by Republicans and the Administration are making it harder and more expensive for people to get the health care they need.
And at a time when the enrollment process is getting more complicated, the Administration has slashed funding for enrollment assistance in states that use HealthCare.gov by 90%, making it harder for people to get free, unbiased help. tradeoffs.org/2025/11/06/t...
Last year’s Republican megabill + federal rule changes are increasing red tape this year and will even more in the next 2 years, making it harder for people to enroll and likely driving healthier folks away from the marketplace (which leads to higher overall premiums). www.cbpp.org/research/hea...
Meanwhile the Trump Administration is considering rule changes that would allow plans with even higher deductibles and reduced protection from high out-of-pocket costs. Some marketplace plans wouldn’t even have a provider network under a proposed change. chir.georgetown.edu/whats-worse-...
Congress and the Administration failed to extend critical financial help in 2025, so most enrollees are paying far higher premiums in 2026. Enrollment is down by >1 M in early data & higher premiums are driving ppl to plans that will require them to pay more for care. www.kff.org/public-opini...
A horizontal bar graph from KFF showing that 80% of returning marketplace enrollees report higher health care costs and that many enrollees are not confident they can afford premiums all year.
This week’s 16th anniversary of the #ACA marks an unfortunate turning point for ACA marketplaces: More people are likely to go uninsured because of affordability concerns and many will face higher health costs, as federal policy decisions that increase premiums and red tape take hold.
Today marks the 16th anniversary of the #ACA. The law covers record numbers of people in #Medicaid and the marketplaces, bans insurer discrimination against people with health conditions, and helps millions afford their health costs. Unfortunately this is all now at risk.
Real talk - the first year of the Trump Administration has made it HARDER for families to afford the basics. #CBPPSOTU
Even as President Trump talks up his health proposals, key decisions he has already made are making care unaffordable for millions. Federal policies he backed will leave some 15M uninsured. If they stood in a line, it would reach from Chicago to Buenos Aires. #CBPPSOTU
New piece from my colleague @nicolerapfogel.bsky.social on why HSAs are more that just a bad deal for people with low incomes -- they can actually be harmful.
On the heels of expired PTC enhancements that resulted in 1 million—and counting—fewer people enrolling in #ACA marketplace plans for 2026, CMS released a proposed rule for 2027 that would reduce marketplace enrollment by 2 million people in 2027 alone. @claireheyison.bsky.social explains:
Dear Mom and Dad: on this Valentine’s Day, I want to thank you with all my heart for all the love and support you have given to me and the confidence you instilled in me as you shared your dreams of what is possible in this great nation. #ToImmigrantsWithLove
#ACA marketplace plan selections are down by more than a million people as of late January, but coverage losses will almost certainly be higher. And the harm stemming from Congressional Republicans' failure to extend PTC enhancements goes much deeper than coverage loss. More in my blog post below.
New KFF poll results: Health care is a top affordability worry, and two-thirds of those surveyed say Congress did the wrong thing not extending the ACA marketplace premium tax credit enhancements. www.kff.org/public-opini...
Excellent thread from my colleague @zoeneuberger.bsky.social on why WIC is so critical for the health of new and expecting parents and young children. Check out the full paper for all the details!
President Trump’s one-page health care plan not only fails to extend enhanced premium tax credits (PTCs), more than doubling out-of-pocket premiums on the ACA marketplace. It also cuts PTCs even further by changing how existing cost-sharing reductions are funded. (1/3) tinyurl.com/37x7wbcz
This “affordability” framework for a second reconciliation bill (i.e. a “Second Big Beautiful Bill”) follows the same structure as its predecessor:
1.)Making it harder for Americans to afford health care, food & groceries.
2.)Tax cuts for rich people. 🧵
Speed and simplicity are paramount. Premiums are due this month. Given the delay in addressing this problem, there is no time for complicated changes. Extending the PTC enhancements is a common-sense solution with bipartisan support and should be enacted without delay. www.cbpp.org/blog/how-to-...
The Senate has an opportunity now to address affordability in a meaningful way that will help millions of families, small business owners, young adults, and workers who can’t afford (or aren’t offered) employer coverage.
Extending PTC enhancements would help millions of people who otherwise would face massive premium spikes afford marketplace coverage as well as other essentials like groceries and rent that working families are struggling to pay. www.cbpp.org/research/hea...
In December, although a nearly identical bill did not meet the 60-vote threshold to overcome the filibuster in the Senate, a majority of Senators supported it, and pressure to enact an extension has grown in recent weeks as people have received January invoices for skyrocketing premiums.
The House passed a measure today to extend the Premium Tax Credit enhancements for three years. The bipartisan vote shows there’s strong support for immediate action to make millions of people’s health care more affordable. All eyes are now on the Senate. x.com/JakeSherman/...
Passing a clean extension ASAP is the simplest and best way to protect health coverage affordability for people who get their coverage from the ACA marketplaces. www.cbpp.org/blog/how-to-...
The House bill would extend the enhancements for 3 years, ensuring the 20 million+ ppl who rely on PTCs can maintain access to affordable coverage that allows them to get the care they need and shields them from medical debt.
Other people are choosing not to enroll at all, because without the PTC enhancements, there simply isn’t an affordable option. It will be months before final enrollment data are available, but millions of people are projected to lose coverage. www.cbo.gov/publication/...
#OpenEnrollment is still underway in every state (except ID). People are deciding now about what they can afford w/o the enhancements. Some are choosing less generous plans than last year, with higher deductibles and other costs b/c it’s now all they can afford. www.nbcnews.com/health/healt...
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...