Mastodawn

Here's how effectuated #ACA exchange enrollment is going in 2026 compared to prior years. The dotted lines show what enrollment would look like for the rest of the year if it follows the same patter as 2025 vs. 2019 (the last pre-COVID year without the enhanced federal subsidies in place).

Charles Gaba 6h ago

NEW: COLORADO Q1 #ACA exchange enrollment down 5.3% y/y; could drop by up to 9.1% or more by the end of 2026:

https://acasignups.net/26/04/13/colorado-q1-effectuated-enrollment-down-53-yy-could-drop-91-or-more-end-2026

Colorado: Q1 effectuated enrollment down 5.3% y/y; could drop by up to 9.1% or more by end of 2026

Connect for Health Colorado, the state's ACA exchange, has published effectuated enrollment data for January, February and March 2026, so it's time to dig in and see what this might say about national trends. Unfortunately, it doesn't provide much demographic data (metal levels, income levels, etc), but it does at least provide the number of effectuated enrollees as well as new and terminated enrollments. Below is what it looks like compared to the same months in prior years. I'm disregarding the COVID years (2020 - 2023) but am including 2016 - 2019 (none of which included the enhanced federal tax credits) as well as 2024 & 2025. Officially, Qualified Health Plan (QHP) selections during Open Enrollment were only 1.9% lower than they were in 2025. However, as I expected and have warned about repeatedly, the year over year drop in effectuated enrollment was double that in January (3.8%), and the gap grew in both February and March. For the first quarter of 2026, effectuated enrollment in Colorado is down 5.3% vs Q1 2025. What might this look like for the rest of the year?

ACA Signups

Charles Gaba ✡️6h ago

NEW: COLORADO Q1 #ACA exchange enrollment down 5.3% y/y; could drop by up to 9.1% or more by the end of 2026: acasignups.net/26/04/13/col...

Colorado: Q1 effectuated enrol...

Colorado: Q1 effectuated enrollment down 5.3% y/y; could drop by up to 9.1% or more by end of 2026

Connect for Health Colorado, the state's ACA exchange, has published effectuated enrollment data for January, February and March 2026, so it's time to dig in and see what this might say about national trends. Unfortunately, it doesn't provide much demographic data (metal levels, income levels, etc), but it does at least provide the number of effectuated enrollees as well as new and terminated enrollments. Below is what it looks like compared to the same months in prior years. I'm disregarding the COVID years (2020 - 2023) but am including 2016 - 2019 (none of which included the enhanced federal tax credits) as well as 2024 & 2025. Officially, Qualified Health Plan (QHP) selections during Open Enrollment were only 1.9% lower than they were in 2025. However, as I expected and have warned about repeatedly, the year over year drop in effectuated enrollment was double that in January (3.8%), and the gap grew in both February and March. For the first quarter of 2026, effectuated enrollment in Colorado is down 5.3% vs Q1 2025. What might this look like for the rest of the year?

ACA Signups

Charles Gaba 12h ago

📣 Final 2026 #ACA Open Enrollment Reporet: Household income over 400% FPL:

Short version: At least *another* half a million middle-class enrollees have been priced out of the market.

https://acasignups.net/2026_oep/final/09

Final 2026 Open Enrollment Report: Household Income (> 400% FPL)

Finally, there's nearly 1.1 million exchange enrollees who earn more than 400% FPL...although this total is actually closer to 2.15 million if you include enrollees whose household income is either "other" or "unknown:" Why is income data not available for all consumers? The application only collects household income data when consumers are requesting financial assistance. Consumers that do not request financial assistance do not enter their household income information and are classified as having an “Other/Unknown FPL.” There are a few SBEs that classify consumers who enter their household income information but are determined not eligible for financial assistance as “Other/Unknown FPL”. As a result, some SBEs report zero plan selections in certain income categories. Please refer to the Public Use Files Definitions document for additional information on these data. There are also a small number of consumers who requested financial assistance but may have missing incomes. For HealthCare.gov states, consumers may have missing incomes due to data anomalies or a tax filing status that makes them APTC-ineligible (e.g., married filing separately).

ACA Signups

Charles Gaba ✡️12h ago

📣 Final 2026 #ACA Open Enrollment Reporet: Household income over 400% FPL: Short version: At least *another* half a million middle-class enrollees have been priced out of the market. acasignups.net/2026_oep/fin...

Final 2026 Open Enrollment Rep...

Final 2026 Open Enrollment Report: Household Income (> 400% FPL)

Finally, there's nearly 1.1 million exchange enrollees who earn more than 400% FPL...although this total is actually closer to 2.15 million if you include enrollees whose household income is either "other" or "unknown:" Why is income data not available for all consumers? The application only collects household income data when consumers are requesting financial assistance. Consumers that do not request financial assistance do not enter their household income information and are classified as having an “Other/Unknown FPL.” There are a few SBEs that classify consumers who enter their household income information but are determined not eligible for financial assistance as “Other/Unknown FPL”. As a result, some SBEs report zero plan selections in certain income categories. Please refer to the Public Use Files Definitions document for additional information on these data. There are also a small number of consumers who requested financial assistance but may have missing incomes. For HealthCare.gov states, consumers may have missing incomes due to data anomalies or a tax filing status that makes them APTC-ineligible (e.g., married filing separately).

ACA Signups

Charles Gaba 2d ago

📣 NEW: Final 2026 #ACA Open Enrollment Report: Household income 200 - 400% FPL

Short version: Several hundred thousand middle-income Americans have been forced into taking a perfectly legal but risky gamble this year...

https://charlesgaba.substack.com/p/final-2026-open-enrollment-report-781

Final 2026 Open Enrollment Report: Household Income (200 - 400% FPL)

Several hundred thousand middle-income Americans are taking a perfectly legal but risky gamble...

Charles Gaba

Charles Gaba ✡️2d ago

📣 NEW: Final 2026 #ACA Open Enrollment Report: Household income 200 - 400% FPL Short version: Several hundred thousand middle-income Americans have been forced into taking a perfectly legal but risky gamble this year... charlesgaba.substack.com/p/final-2026...

Final 2026 Open Enrollment Rep...

Final 2026 Open Enrollment Report: Household Income (200 - 400% FPL)

Several hundred thousand middle-income Americans are taking a perfectly legal but risky gamble...

Charles Gaba

Scary Austin 3d ago

#MAGA Mike Johnson is able for now to keep Congress out of session so the #Democrats (and doubtless some #GOP defectors) can't stop the war.

But he is in real trouble.

https://www.jezebel.com/mike-johnson-too-scared-to-defund-planned-parenthood

#healthcare #medicaid #ACA

Well, Well, Well, Look Who’s Too Scared to Defund Planned Parenthood Now

With the GOP likely to lose its trifecta in November, House Speaker Mike Johnson is suddenly not worried about Medicaid money funding what he's called "big abortion."

Jezebel

Bich Nguyen 3d ago

"But because states have passed laws exempting farm bureau health plans from health insurance requirements, they don’t offer many of the coverage protections provided by insurance. That means their benefits and coverage rules may be less generous or predictable than Obamacare plans."

https://kffhealthnews.org/news/article/farm-bureau-plans-less-pricey-alternative-aca-coverage-tradeoffs/

#healthcare #insurance #ACA #RuralHealth #CostsOfCare

Farm Bureau Plans Are a Less Pricey Alternative to ACA Coverage — With Trade-Offs - KFF Health News

Fourteen states now allow health coverage through state farm bureaus. Though they generally share many features of Affordable Care Act marketplace plans, they aren’t insurance. Neither are they typically subject to federal or state health insurance requirements, and the benefits may be less generous or predictable than those of Obamacare plans.

KFF Health News

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Charles Gaba ✡️5d ago

Unfortunately, via the #BigUglyBill and #TrumpRegime policy changes, that population is no longer eligible. Result: #ACA exchange enrollment of those who earn less than 100% FPL (just $15,650/yr if you're single) plummeted by 45%, w/over 240,000 losing coverage.