Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.
Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).
In any event, most of the material discussed in their story is pretty much everything I've been writing about and warning about for months, and even the enrollment data they acquired is the same as what I have in most cases. They were, however, able to get ahold of hard effectuation numbers for three states which I didn't already know: Arkansas, Nevada and Vermont.
Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.
Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).
In any event, most of the material discussed in their story is pretty much everything I've been writing about and warning about for months, and even the enrollment data they acquired is the same as what I have in most cases. They were, however, able to get ahold of hard effectuation numbers for three states which I didn't already know: Arkansas, Nevada and Vermont.
Once again: The true measure of ACA healthcare coverage enrollment isn't how many people select policies during the Open Enrollment Period, it's how many actually have those policies in effect (aka "effectuated enrollment")...as well as how comprehensive that coverage is, of course.
Yesterday, Pluribus News published a new story about effectuated enrollment across a dozen or so states (the reporters actually consulted with me several times about their data and how to present it, although I somehow didn't end up getting credited in the final version).
Providence to end most health insurance plans, forcing hundreds of thousands in Oregon to switch
Providence Health & Services plans to exit most of its Oregon health insurance business next year, citing rising costs, tougher regulation and intensifying competition from national insurers — a move that will force hundreds of thousands of Oregonians to find new coverage.
Leaders of the Renton, Washington-based health system announced the decision Wednesday, saying Providence will stop offering most plans through Providence Health Plan,including individual, family and employer coverage, as it seeks to strengthen its financial footing and refocus on delivering care rather than operating an insurance arm.
So, what does this mean for monthly effectuated enrollment this year? Well, it's pretty safe to say that it's not going to look anything like the ePTC years [ie, 2021 - 2025]; in fact, at least a half-dozen state-based ACA exchanges have posted press releases warning that they're already seeing record levels of plan cancellations.
Instead, it seems pretty clear that the pattern is much more likely to resemble one of the NON-ePTC years. Here's what it would look like if effectuations in 2026 follow the exact path of those years...
...Depending on which year it mimics, average 2026 effectuations will range somewhere between 18.2 million - 20.9 million per month. If so, this would mean anywhere from 1.4 - 4.1 million fewer exchange enrollees than 2025.
Federal Premium Tax Credits have been an important aspect of affordability for marketplace enrollees since the adoption of the Affordable Care Act. Premium tax credits lower the cost of private health plans available through the marketplace and are based on income and household size.
Since 2021, Enhanced Premium Tax Credits (EPTC) totaling $600 million annually in Pennsylvania alone made coverage more affordable than ever for enrollees. As a result, Pennie saw enrollment increase by 50% from 2021 to 2025. Pennie enrollment reached its highest point at half a million total enrollees in 2025. The enhanced tax credits expired at the end of 2025, and Pennie enrollees saw costs double on average to keep their plan in 2026.
