🚨🚨🚨 CBO: " #MAGAMurderBill will kick 8.2M ACA enrollees off their coverage!" Wakely Consulting: "Hold our beer." New white paper projects up to *~14 MILLION* losing ACA exchange or BHP coverage between House GOP budget bill + IRA subsidy expiration: acasignups.net/25/06/24/mag...

MAGA Murder Bill: CBO: "8.2M w...
MAGA Murder Bill: CBO: "8.2M will lose ACA coverage!" Wakely: "Hold our beer."

A few weeks ago, the Congressional Budget Office (CBO) issued their official projection of just how much damage the combined effect of the House GOP's budget reconciliation bill (officially the "One Big Beautiful Bill Act") would cause to healthcare coverage in the U.S.: Over 16 million Americans would lose coverage, over half of whom (~8.2 million) are currently enrolled in ACA exchange plans. If this happens, it would mean the ACA exchange market would drop by more than 1/3 from the ~24.2 million currently enrolled (myself & my own family included). However, I've repeatedly stated that even this is likely a low estimate--the remaining ~16 million exchange enrollees would still be hit with MASSIVE (and in some cases eye-poppingly huge) premium hikes which would force them to drop to far worse plans (meaning much higher deductibles & co-pays; worse provider networks and so on). There's also the ripple effect of insurance carriers either shrinking their footprint or dropping out of the exchange market altogether, as Aetna/CVS recently announced.

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This includes up to *64%* of ACA enrollees in NON-EXPANSION STATES losing coverage. THAT WOULD BE OVER 5.5 MILLION IN FLORIDA & TEXAS ALONE. 👀
Combined w/the ~7.8M expected to lose Medicaid coverage, that's potentially up to 21.8 million Americans losing healthcare coverage as a result of the #MAGAMurderBill + IRA subsidy expiration.
Also worth noting: I recently ran an analysis of how many would lose either ACA exchange or Medicaid coverage at the House District level based on the CBO's 16M projection. My conclusion was that it'd hit both red & blue districts roughly equally... acasignups.net/25/06/18/red...

Red v. Blue: Who'd be screwed ...
Red v. Blue: Who'd be screwed most by the #MAGAMurderBill? (Revisited)

Last month, in response to House Republicans passing their version of the budget resolution bill, I broke out total enrollment in Medicaid via ACA expansion, ACA exchange Qualified Health Plan (QHP) enrollment and ACA-based Basic Health Plan (BHP) enrollment by Congressional District in order to try and get a sense of just how many Americans healthcare coverage is at risk from the bill...and how that breaks out along partisan lines at the House District level. As I noted at the time, Republicans seem to be under the impression that it will mostly be Democrats who get screwed by their bill, since 9 of the 10 non-expansion states are Republican strongholds...while some Democrats seem to be under the impression that it will mostly be rural MAGA republicans who get screwed. I further noted that while most of the attention has been on the ~20 million people enrolled in Medicaid via ACA expansion, there are actually more people (~24 million) enrolled in ACA exchange plans, which are also in deep trouble from both the bill itself as well as the GOP allowing the enhanced IRA subsidies to expire, as well as the Trump Administration's so-called "Integrity Rule" which would cause further damage to ACA exchange enrollees once implemented.

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...HOWEVER, if Wakely proves more accurate re. ACA exchange losses, the red/blue divide would change dramatically, for two reasons: 1. There's ~1/3 more ACA exchange enrollees in red districts than blue districts to begin with; and 2. Wakely expects the loss % to be higher in NON-expansion states.
I'll run the CD-level numbers based on the CBO's Medicaid estimate + Wakely's ACA exchange estimate this afternoon. It will definitely tip the balance over to red district, just not sure by how much.
UPDATE: OK, that was actually easier than I thought. If I assume the CBO's Medicaid estimate is accurate (~7.8M losing coverage) while using the midpoint of the Wakely projections for ACA exchange losses (~12.7M losing coverage), here's how it would break out between red & blue districts:
...and here's what it would look like when broken out into brackets based on partisan lean. Again, still a SHITLOAD of people losing coverage across the ideological spectrum, but this time with a slight lean towards higher losses in redder districts.
In th is scenario, the House district with the largest total number of residents losing healthcare coverage in the country would be #FL27, where over 178,000 of Maria Elvira Salazars (R) constituents would become uninsured. That'd be 23% of the total population of her district.
P.S. If you find my healthcare wonkery useful & would like to support it, you can do so here either once or monthly, thank you! secure.actblue.com/donate/acasi...

I just supported Charles Gaba'...
Since this post/thread are getting some attention, here's state-by-state examples of how much *net* premiums are likely to skyrocket for various households at various income levels if the IRA subsidies expire alone (ie, this doesn't even include the bill itself): acasignups.net/ira-subsidy-...

How much more will ACA enrolle...
How much more will ACA enrollees have to pay if the enhanced subsidies expire? (updated)

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 version even worse, like so: I should also note that I've started cross-posting key entries at Substack as well. 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.

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I'm basing this on the 2025 benchmark Silver plan and assuming the enrollees live in the capital city of each state. The household examples I'm using: --a 50-yr old single adult --a 30-yr old single parent w/an 8-yr old child --a 40-yr old couple w/2 children age 15 & 12 --a 64-yr old couple
It's important to note that the benchmark Silver plan varies from county to county, and even then it will be likely change from 2025 to 2026. The incomes I'm using in these examples range from $20K - $130K depending on the household.