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: 🧵

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...

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...

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...

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 👇

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...

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. 👇

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. 🧵

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: 🧵

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:

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...

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..."

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.

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...

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...

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:

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.

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

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.

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.

Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.

Today, the Senate Finance Committee held a hearing on rising health care costs. But the real, urgent focus should be that 20 million people would face higher premium costs if the PTC enhancements expire at the end of the year. Here’s how real people will are affected.

My colleague @nicolerapfogel.bsky.social talked with CQ this week about why Republican HSA and cash account proposals are no substitute for extending the soon-to-expire PTC enhancements that more than 20 million ACA marketplace enrollees rely on to keep coverage affordable.

As I told CQ, the Republican HSA and other cash account proposals are no real alternative to extending PTC enhancements and won't make health coverage more affordable. “These proposals are somewhat unserious. They lack the details, they're unclear on the mechanisms, they don't make policy sense.”

Expanding HSAs would do nothing to address impending premium increases for some 22 million people with low/moderate incomes who are facing higher costs. Instead, Congress should extend premium tax credit enhancements to ensure enrollees continue to have access to affordable health coverage.

HSAs are tax shelters masquerading as health policy. They don't help people who are struggling to afford health coverage. Read more from @nicolerapfogel.bsky.social: tinyurl.com/fh5rabhx

Open enrollment for #ACA marketplace plans has begun, and without congressional action to extend premium tax credit enhancements, millions are facing steep premium increases for 2026.

Georgia’s 2026 ACA marketplace window shopping began October 1, meaning people are already seeing next year’s premiums spike because of expiring tax credit enhancements. A typical 60-year-old couple making $85,000 in Georgia will face a $24,900 increase in annual premiums. (1/4)

Some policymakers say that that Congress can delay extending the Premium Tax Credit (PTC) enhancements until later this year but the problem is more urgent than that. thehill.com/policy/healt...

Since 2021, ACA marketplace enrollment more than doubled for people with low incomes and for Black and Latino enrollees after premium tax credit enhancements. (1/4)

Premium tax credit enhancements help tipped workers, veterans, small business workers, farmers, and older people afford health coverage. Their premiums will soon spike and millions of them will lose coverage if the enhancements expire. (1/5)

As Democrats push to reverse the megabill’s health care cuts and stop imminent cost increases in the marketplaces, Republicans have made false claims about who would benefit from these restorations in affordable health coverage. www.americanprogressaction.org/article/repu...

If Congress allows the enhanced premium tax credits to expire at the end of this year, ACA Marketplace enrollees on average would see their out-of-pocket premium payments grow by 114%, from an average of $888 in 2025 to $1,904 in 2026: https://on.kff.org/3WfWxjj

Why are #ACA marketplace plans with $0 premiums important? My colleague @nicolerapfogel.bsky.social explains:

NEW from @centeronbudget.bsky.social: Without Congressional action, premium tax credit enhancements will expire, raising costs for nearly all marketplace enrollees and putting millions of those with the lowest incomes at risk of becoming uninsured when they lose $0 premium plans.

More than 2 in 5 veterans enrolled in the ACA marketplace will lose their coverage if premium tax credit enhancements expire, out of the 623,000 veterans who would otherwise have marketplace coverage in 2026. New Urban Institute estimates here: tinyurl.com/2bs4aj2j

NEW from @jenniferlsullivan.bsky.social and me for @centeronbudget.bsky.social: With Congress poised to take away premium tax credit enhancements soon, ~4M people will lose coverage and costs will rise for nearly all ACA marketplace enrollees unless Congress acts.🧵

My colleague @nicolerapfogel.bsky.social and I write about five key changes coming to #ACA marketplaces this fall. TLDR? Nearly all enrollees will face higher costs unless Congress extends the Premium Tax Credit enhancements.

Eliminating the PMF program as President Trump ordered could mean losing a new generation of bright public servants. PMF alums @andrewpmiller.bsky.social and Kelly Razzouk explain in @justsecurity.org:

In addition to restricting marketplace eligibility and increasing burdensome red tape in the budget bill, CMS finalized a rule that would cause 1.8M people to lose coverage in 2026 alone. More on the details and major issues 👇

Up to 1.8M people will lose #ACA marketplace coverage in 2026 alone under a new federal rule that will make coverage less affordable for enrollees. More from @nicolerapfogel.bsky.social: www.cbpp.org/research/fed...

The new CBO score is out for the "Big Beautiful Bill." Topline? 10.9m people will lose coverage. Combined with previous CBO estimates (updated numbers could be coming soon) of cuts slated for the end of the year for ACA premium tax credits we could be looking at 16m uninsured. Disgraceful.