Health policy research organization
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Produced the 114% premium spike estimate that framed the subsidy-cliff debate
The ACA subsidy cliff has delivered the predicted damage. Enhanced premium tax credits expired on January 1, 2026, and by late January, enrollment data confirmed the worst fears: 1.2 to 1.4 million fewer Americans signed up for marketplace coverage compared to the prior year, with total 2026 enrollment falling to 22.8–22.9 million. Average premium payments for subsidized enrollees jumped 114% as projected—from $888 to $1,904 annually—while Trump administration changes to tax credit calculations amplified the shock. State exchanges reported steep declines: California saw new sign-ups fall 32%, Massachusetts lost 13,000 enrollees, and Mississippi expects 200,000 to abandon coverage. The predicted rate shock is no longer a forecast; it is reshaping the individual insurance market in real time.
Updated Feb 6
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