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.
Medicare Advantage (technically "Medicare Part C" & originally called "Medicare+Choice") is a type of health plan in the United States offered by private companies as part of the original Social Security Act of 1965 that created Medicare. It permits a private insurance option that wraps around traditional Medicare. Medicare Advantage plans attempt to fill some coverage gaps and offer alternative coverage options.
Under Part C, Medicare pays a plan operator a fixed payment for each enrollee. The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).
Last month I posted a massive3-partseries of articles which looked at nearly 3 dozen changes being proposed by the Trump Regime's Centers for Medicare & Medicaid Services (CMS) to how the Affordable Care Act will be administered starting this fall (for the 2027 plan year).
The changes ranged from the mundane (for instance, one provision simply says that the per enrollee user fees paid by insurance carriers to HHS to pay for HealthCare.Gov's operations will remain the same as they are this year) to the devastating (up to 1.5 million legally-present immigrants who were previously eligible for ACA tax credits, including victims of domestic abuse and human trafficking, either already are or will soon become ineligible for financial assistance).
Medicare Advantage (technically "Medicare Part C" & originally called "Medicare+Choice") is a type of health plan in the United States offered by private companies as part of the original Social Security Act of 1965 that created Medicare. It permits a private insurance option that wraps around traditional Medicare. Medicare Advantage plans attempt to fill some coverage gaps and offer alternative coverage options.
Under Part C, Medicare pays a plan operator a fixed payment for each enrollee. The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).
It may not make any difference but believe it or not sometimes it does, even under the Trump regime...and in fact in some cases they're actively stating that they're seeking comment as opposed to just ramming the proposed changes through.
The Patient Protection & Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
It may not make any difference but believe it or not sometimes it does, even under the Trump regime...and in fact in some cases they're actively stating that they're seeking comment as opposed to just ramming the proposed changes through.
The Patient Protection & Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
UPDATE: Someone correctly pointed out that it’s a bit unfair to tell people to “be afraid” without giving them any action items to try and stave off the uglier changes being proposed. You have until March 13th to submit a comment to CMS. It may not make any difference but believe it or not sometimes it does, even under the Trump regime.
The Patient Protection & Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
