New CBO report projects that federal subsidies for employer coverage will be 6X larger than ACA marketplace premium tax credits over 2026-2036. [1/5] www.cbo.gov/publication/...

Federal Subsidies for Health Insurance, 2026 to 2036

Federal subsidies for health insurance total $33.6 trillion over the 2026–2036 period in CBO and JCT’s projections. Those estimated subsidies grow from 7.4 percent of gross domestic product (GDP) in 2...

cbo.gov

Nearly every state saw ACA marketplace enrollment drop after the PTC enhancements expired, but some states fared worse than others. See how your state was impacted: www.cbpp.org/blog/aca-mar...

ACA Marketplace Enrollment Shrank in Nearly Every State After Premium Tax Credit Enhancements Expired

Enrollment in the Affordable Care Act marketplaces shrank in nearly every state after premium tax credit enhancements expired.

cbpp.org

New data show that #ACA marketplace enrollment fell by ~3 million people as premiums spiked following the failure of Congressional Republicans to extend PTC enhancements. This is Feb 2026 data - expect further coverage loss as the year goes on and monthly premiums pile up.

With millions struggling to afford health care and coverage, Trump and Republicans in Congress have once again pointed to expanding health savings accounts (HSAs) as a solution. But HSAs don’t solve affordability problem. Here are 5 reasons why: 🧵

Five Reasons HSAs Aren’t the Answer to the Health Care Affordability Crisis

In the wake of their actions that have worsened health care affordability, President Trump and some in Congress have pushed expanding health savings accounts (HSAs). The problem is HSAs are not the an...

cbpp.org

As some House Rs call for reconciliation 3.0, many want to expand health savings accounts. But HSAs mainly benefit higher-income people, and they do little to improve affordability for those struggling the most with health costs. read more by @nicolerapfogel.bsky.social www.cbpp.org/blog/five-re...

Five Reasons HSAs Aren’t the Answer to the Health Care Affordability Crisis

In the wake of their actions that have worsened health care affordability, President Trump and some in Congress have pushed expanding health savings accounts (HSAs). The problem is HSAs are not the an...

cbpp.org

My colleague @nicolerapfogel.bsky.social and have a new blog on the final ACA marketplace rule for 2027, which weakens consumer protections and pushes people towards lower-quality plans that put them at risk of higher out-of-pocket costs. www.cbpp.org/blog/new-fin...

New Final Rule Pushes Marketplace Enrollees Toward Lower-Quality, More Expensive Coverage

A new Affordable Care Act marketplace rule finalized by the Centers for Medicare & Medicaid Services adds to the burdens of millions of people in the United States who are already struggling to afford...

cbpp.org

Today is #Oklahoma ’s first day as a state-based marketplace on the federal platform (SBM-FP). The state will now certify #ACA plans and run its own consumer outreach program. The change was approved less than a month ago, making this the fastest SBM-FP transition to date. A few things to watch 👀

When Marketplace enrollees filed their taxes this spring, they may not have realized it’d be the last year with key financial protections in place. Starting next year, they’ll face higher taxes due to the Republican megabill. www.cbpp.org/blog/marketp...

Marketplace Enrollees Could Face Surprise Tax Increases Next Year Thanks to the Republican Megabill

Eliminating the APTC repayment caps is expected not only to reduce marketplace enrollment over time but also to raise premium costs for those who remain enrolled.

cbpp.org

The Trump admin and Congressional Republicans have pushed to expand health savings accounts. But as I told @nytimes.com, “Health savings accounts are effectively a tax shelter for the wealthy.” More on why HSAs don't help people with low incomes access comprehensive coverage and afford care 👇

Health Savings Accounts Can Be a Bad Deal for Low-Income Marketplace Enrollees

In the wake of their actions that have worsened health care affordability, President Trump and Republicans in Congress have pushed to expand health savings accounts (HSAs). But this doubles down on an...

cbpp.org

Christina Jewett@by-cjewett.bsky.social · 5mo ago

NEW: Calley Means, a top advisor to Kennedy/Trump, held $25-$50M in stock & was president of his wellness company last year while he advised on health policy. His company benefits from more HSAs. He said he had no role in HSA expansion. w/@benjmueller www.nytimes.com/2026/04/24/h...

Following the expiration of PTC enhancements, #ACA marketplace plan selections dropped by 1.2 million during the 2026 open enrollment period. A new analysis suggests that millions more will drop coverage over the year as enrollees confront higher monthly premiums. www.wakely.com/blog/who-pai...

Who Paid, and Who Stayed? Early 2026 Enrollment Trends in the Individual Market - Wakely

A new report from Wakely Consulting Group, an HMA Company, models changes to the 2026 ACA market enrollment due to the loss of federal subsidies. Findings

wakely.com

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. 👇

Nicole Rapfogel@nicolerapfogel.bsky.social · 6mo ago

Following the expiration of enhanced PTCs, new 2026 open enrollment data show marketplace enrollees are paying much more for coverage—even as they shift into lower-premium but less generous plans that leave them with higher deductibles when they need care. 🧵

Following the expiration of enhanced PTCs, new 2026 open enrollment data show marketplace enrollees are paying much more for coverage—even as they shift into lower-premium but less generous plans that leave them with higher deductibles when they need care. 🧵

New Data Show Marketplace Consumers Facing Higher Costs, Selecting Lower-Quality Coverage

New open enrollment data for 2026 show that people are paying much more for marketplace coverage following the expiration of premium tax credit (PTC) enhancements, even as they shift into lower-premiu...

cbpp.org

Marketplace enrollees’ premiums have skyrocketed following the recent expiration of PTC enhancements. Some have suggested health savings accounts and less generous plans as a more affordable alternative to comprehensive coverage. Here’s why that line of reasoning is flawed: 🧵

Health Savings Accounts Can Be a Bad Deal for Low-Income Marketplace Enrollees

In the wake of their actions that have worsened health care affordability, President Trump and Republicans in Congress have pushed to expand health savings accounts (HSAs). But this doubles down on an...

cbpp.org

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:

CMS Proposed Rule Would Reduce ACA Marketplace Enrollment by 2 Million People

February 09, 2026: A new proposed rule from the Centers for Medicare and Medicaid Services (CMS) to make broad changes to the Affordable Care Act (ACA) marketplaces would reduce marketplace enrollment...

cbpp.org

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/...

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...

Marketplace Enrollees In Every Congressional District Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended

Annual premium increase, 60-year-old couple with income of $85,000 (401% FPL), by congressional district, 119th Congress Note: FPL = federal poverty level. Examples are based on 2026 average...

cbpp.org

What a mess: "For example, a 60-year-old earning $63,000 would face a premium for a silver plan of $17,200 per year – more than one-fourth of their annual income..."

Nicole Rapfogel@nicolerapfogel.bsky.social · 9mo ago

The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements. Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.

The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements. Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.

House Republican Health Care Bill Fails to Address Marketplace Affordability

The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise....

cbpp.org

This week is critical for health coverage affordability. CBPP’s @jenniferlsullivan.bsky.social breaks down what’s at stake as Congress votes on extending premium tax credit enhancements & the 3 key dates marketplace enrollees need to know when choosing 2026 coverage: www.youtube.com/watch?v=6QY5...

3 Key Dates to Keep in Mind When Choosing Your Health Coverage Plan for 2026

YouTube video by Center on Budget and Policy Priorities

youtube.com

Tracy, 57, from GA, received this notice showing her #ACA marketplace premium rising from $82 to $1,616/month if premium tax credit enhancements expire — nearly a $19k increase next year. For her, that means choosing between coverage and essentials.

Even small premium payments make it more difficult to enroll in and maintain health coverage, especially for people with low incomes. If the enhanced tax credits expire the cost will hurt millions of families. Via @CenterOnBudget: momsrising.org/CBPPpremiumplans #TrumpInflationCrisis

Sens Cassidy and Crapo are circulating a health proposal that would do little to address the premium spikes millions of ACA marketplace enrollees will face starting Jan 1, and would further increase many people’s out of pocket costs for health care over time. www.axios.com/2025/12/08/s...

Scoop: Senate GOP chairs circulate health plan as ACA subsidies hang in the balance

Two key Republican chairmen circulated the plan as the GOP struggles to unite around health policies.

axios.com

New HHS data on ACA marketplace enrollment for 2026 so far suggest a similar number of ppl have selected a plan compared to last year even as they see higher premium costs that reflect expiration of PTC enhancements. But don't make too much if it.

Sweeping federal policy changes are threatening people's access to affordable health coverage and care — but state insurance regulators and other state leaders can help stem the damage. A new report from NAIC consumer representatives explains how:

NAIC Consumer Representative Report: Recommendations for States’ Efforts to Mitigate Harms Caused by Federal Policy Actions - Consumer Health Reps at NAIC

consumeradvocacyforhealth.org

As new proposals addressing expiring PTC enhancements emerge, it's important to be clear about what makes a strong (or not so strong) proposal. My colleague @jenniferlsullivan.bsky.social lays out key guidelines for evaluating these proposals.

Jennifer Sullivan@jenniferlsullivan.bsky.social · 10mo ago

Proposals to address expiring PTC enhancements should be evaluated based on the extent to which they: 1. avoid making more people uninsured; 2. ensure people keep access to affordable, comprehensive coverage; and 3. can take effect quickly. More here: www.cbpp.org/blog/how-to-...

Instead of a clean extension of PTC enhancements (which makes silver plans more affordable), some Republicans have proposed encouraging people to buy down to less generous bronze plans. Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.

ACA marketplace plans w/ $0 premiums help ppl get & stay covered. Recent Republican proposals would require minimum premiums or fail to extend premium tax credit enhancements based on the false claim that ppl who don’t use medical care are “phantom enrollees.” 🧵https://tinyurl.com/4uc68zbf

People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts

Without congressional action, PTC enhancements will expire at the end of 2025. This will cause millions —many of these lowest-income enrollees especially — to become uninsured, or to face impossible c...

tinyurl.com

As I was quoted in this article: "Most people do not have spare cash to set aside in HSAs." HSAs don't help the people with low and moderate incomes most affected by expiring PTC enhancements, don't help people get health coverage, and just don't make sense for most Americans.

The Washington Post@washingtonpost.com · 10mo ago

Republicans facing voter ire over spiking health premiums are resurrecting one of their favorite ideas: give people power to pay for medical care on their own, with tax-free dollars in individual health savings accounts.

Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?

The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.