Thanks to New Mexico backfilling 100% of ALL lost federal tax credits for EVERY ACA exchange enrollee in the state who was eligible for subsidies last year, their average monthly enrollment total is actually higher than it was in 2025 in spite of Congressional Republicans allowing the enhanced federal subsidies to expire at the end of 2025. Initial signups during Open Enrollment were actually up a whopping 18% vs. OEP 2025.

Even so, effectuated enrollment has still gradually declined over the course of the year so far...from 15% higher year over year in January to just 0.5% higher as of July...and this month it actually slipped slightly below the August 2025 tally (New Mexico is one of a handful of states which provide timely, monthly effectuated enrollment data reports).

The monthly average is still 6.5% higher than it was through August of last year, but I could see this drifting down to just 1-2% higher, or roughly even year over year by December.

ACA exchange enrollment has dropped by 11.4% in New Jersey since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year...despite NJ offering state-based subsidies to help mitigate the lost federal assistance.

Initial signups during Open Enrollment were only down 0.8% vs. OEP 2025...but effectuated enrollment was 4.4% lower year over year in January, gradually rising to 11.4% lower as of April, according to Get Covered NJ, the state ACA exchange.

That's over 56,000 Kansans who already lost coverage in just the first four months of the year...a number which has likely continued to climb since then.

ACA exchange enrollment has dropped by more than 11% in Montana since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were only down 5.1% vs. OEP 2025...but effectuated enrollment was 7.6% lower year over year in January, rising to 11.4% lower as of February.

The effectuated enrollment numbers have likely continued to drop more since then (the raw numbers aren't that eyebrow-raising since Montana is a small state, population-wise).

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

ACA exchange enrollment has dropped by more than 26% in Mississippi since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were already down 7.3% vs. OEP 2025...but effectuated enrollment was 16.9% lower year over year in January and  26.4% lower as of February.

That's over 68,000 Mississippians who already lost coverage in just the first two months of the year...a number which has almost certainly continued to get worse since then.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

ACA exchange enrollment has dropped by 7.8% in North Dakota since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of 2025.

Initial signups during Open Enrollment were down 4.4% vs. OEP 2025...but effectuated enrollment was 5.7% lower year over year in January and down 7.8% as of February.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

ACA exchange enrollment has dropped by 23% in Nebraska since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were only down 5% vs. OEP 2025...but effectuated enrollment was 22% lower year over year in January and 23% lower as of February (although, interestingly, effectuated enrollment actually increased slightly from January to February both years).

That's nearly 30,000 Nebraskans who already lost coverage in just the first two months of the year...a number which has likely continued to climb since then.

ACA exchange enrollment has dropped by 20% in Kansas since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were only down 3.6% vs. OEP 2025...but effectuated enrollment was 9.3% lower year over year in January, rising to 20% lower as of February.

That's over 36,000 Kansans who already lost coverage in just the first two months of the year...a number which has likely continued to climb since then.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

ACA exchange enrollment has dropped by nearly 30% in Arizona since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were already down 15.6% vs. OEP 2025...and effectuated enrollment was 23% lower year over year in January, rising to nearly 30% by February.

That's over 107,000 Arizonans who already lost coverage in just the first two months of the year...a number which has likely continued to climb since then.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

ACA exchange enrollment has dropped by nearly 23% in Alabama since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.

Initial signups during Open Enrollment were already down 4.6% vs. OEP 2025...but effectuated enrollment as of January 2026 was down over 9% year over year...increasing to a 22.5% drop as of February.

That's over 94,000 Alabamans who already lost coverage in just the first two months of the year...a number which has likely continued to climb since then.

Here's what this looks like visually, with both 2025 and 2019 (the last pre-COVID year, which didn't include the enhanced subsidies) included for comparison:

I'm exactly halfway through my annual state-by-state individual & small group health insurance market rate filing analysis project, so this seems like a good time to take a moment to check in and see where things stand overall.

As of today, I've compiled the preliminary 2027 rate filings for the ACA-compliant individual and small group markets across 25 states (including the District of Columbia). So far, the weighted average increases being requested range from as little as 6.5% in Vermont to as much as 22.9% in Alaska. Interestingly, both of these states already have some of the highest individual market premiums for unsubsidized enrollees in the nation...over $1,000 per month per enrollee.