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).
The past couple of weeks have been pretty brutal for the Oregon health insurance market.
On May 21st, Providence Health Plan announced that they were shutting down pretty much their entire insurance division across Oregon (which also impacts some people in Washington and California):
Providence Health & Services plans to exit most of its Oregon health insurance business next year, citing rising costs, tougher regulation and intensifying competition from national insurers — a move that will force hundreds of thousands of Oregonians to find new coverage.
...Providence Health Plan, based in Portland, is Oregon’s third-largest health insurer, covering more than 421,000 Oregonians. It also covers over 13,000 members in Washington and 4,800 in California.
Mending Health Notifies Maine Bureau of Insurance that it Will Cease Offering Health Insurance Plans
AUGUSTA, ME – Mending Health, formerly known as Taro Health, has notified the Maine Bureau of Insurance that it will no longer offer health insurance as of January 1, 2027.
Mending Health’s approximately 1,100 members will keep their health plans through the end of their existing plan year.
Individuals/families who obtained Mending coverage through CoverME.gov, or who purchased a plan directly from Mending Health, can select a new plan with another health insurance company during the annual open enrollment period beginning November 1, 2026. New coverage will take effect January 1, 2027.
Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
ACA exchange enrollment has dropped by more than 10% in Florida since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were only down 4% vs. OEP 2025...but effectuated enrollment was 7.7% lower year over year in January, rising to 10.3% lower as of February.
That's over 440,000 Floridians who already lost healthcare 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 exchangeenrollment has only dropped by about 4% in Texas since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were actually up about 5% vs. OEP 2025...but effectuated enrollment quickly dropped to practically even year over year in January and was down 4.3% as of February.
Still, thanks largely to Texas having a robust Premium Alignment policy in place (which they boosted a bit more this year, as I understand it), the drop-off in the Lone Star state has been far more modest than in most of the country. Even so, that's still over 146,000 Texans who lost healthcare coverage in just the first two months of the year.
ACA exchange enrollment has dropped by 10% in Arkansas since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were only down 3.8% vs. OEP 2025...but effectuated enrollment was down over 8% year over year in January and by 10% (around 14,000 enrollees) as of February.
ACA exchange enrollment has dropped by 32% in Ohio since Congressional Republicans allowed the enhanced federal subsidies to expire at the end of last year.
Initial signups during Open Enrollment were down nearly 20% vs. OEP 2025...but effectuated enrollment dropped further, by 23% year over year in January and by over 32% in February.
That's over 160,000 Ohioans who already lost coverage in just the first two months of the year...a number which has likely continued to climb since then.
