In 2020, Oklahoma voters passed Medicaid expansion, adding more people to Soonercare. Republican lawmakers are advancing proposed constitutional changes to reverse that vote: House Bill 4440 and House Joint Resolution 1067.
If approved, both state questions would give lawmakers the ability to adjust or reverse Oklahoma’s expanded Medicaid eligibility without a majority vote of approval by Oklahomans, with one acting as a failsafe in case the other is unsuccessful during the Aug. 15 primary runoff.
...Both measures passed the Senate Rules Committee along party lines on Monday.
Democrats say the process to approve the measures in the Senate feels ‘intentionally chaotic.’
Expanded Medicaid eligibility extends government-subsidized health coverage to adults aged 19-64 with incomes up to 138% of the federal poverty level. Today, adults made eligible by the expansion vote account for just over a fifth of all Oklahomans enrolled.
The Cigna Group disclosed plans to exit the individual health insurance business under the Affordable Care Act, also known as Obamacare, leaving about 369,000 health plan members in 11 states looking for new coverage in 2027.
The decision, disclosed Thursday, a day when Cigna reported $1.7 billion in first quarter net income, comes as more Americans can no longer afford Obamacare after the Republican-led Congress and the Trump administration failed to renew enhanced subsidies.
Already, enrollment in the individual plans Cigna sells dropped 17% to 369,000 in the first quarter compared to 446,000 in the first quarter of last year, the company said in its first quarter earnings report. Enrollment in Cigna’s individual coverage was flat when compared to the end of last year despite adding 20 new counties to the more than 370 counties across 11 states where the company has sold Obamacare.
Maryland Health Connection is one of the handful of states operating their own ACA exchanges which publishes effectuated enrollment data on a monthly basis, so let's take a look...
Maryland is one of the ten states in which Qualified Health Plan (QHP) selections during Open Enrollment actually increased year over year (by 3.4%).
Unlike the other five states I've written updates about so far, however, Maryland is unique in that it's the first state I've seen in which the year over year increase has grown a bit over time...at least as of March, anyway. Effectuated enrollment was 12.6% higher in January, 4% higher in February and 2.3% higher in March, for a Q1 average effectuated enrollment 6.1% higher than Q1 of 2025:
Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...
Republicans know how unpopular all this will be. So they’ve structured the bill so the tax cuts land immediately, while many of the Medicaid cuts get going in 2027 and 2028. That’s meant to spare them in the midterms.
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).
More than half a million Georgians have dropped health insurance coverage amid stiff premium price hikes for federally subsidized Affordable Care Act plans, according to data obtained by The Current GA and Georgia Recorder.
The 37% enrollment drop — from 1.5 million Georgians in January 2025 to 950,000 as of April 17, 2026 — dwarfs any previous decline in the state since the launch of so-called Obamacare health insurance plans in 2014.
Cost Increases from Washington’s Inaction Drives nearly 70,000 New Jerseyans to Drop Health Coverage since January
Expiration of Federal Subsidies Increase Health Care Costs for Working and Middle-Class New Jerseyans
Residents Urged to Stay Covered to Protect Their Health and Avoid Higher Out-of-Pocket Health Care Costs
TRENTON — -- Inaction by the Trump Administration and Congress to extend federal enhanced premium tax credits for consumers purchasing coverage through health insurance marketplaces under the Affordable Care Act has resulted in nearly 14% of those initially enrolled in health plans through Get Covered New Jersey to drop their coverage. As of April 15, 2026, total enrollment on the State Exchange stood at 440,362 – reflecting a net loss of 68,830 enrollees since the end of Open Enrollment.
The Massachusetts Health Connector is one of the handful of states operating their own ACA exchanges which publishes effectuated enrollment data on a monthly (actually weekly) basis, so let's take a look...
Officially, Massachusetts is one of the ten states in which Qualified Health Plan (QHP) selections during Open Enrollment actually increased year over year (by 3.7%).
However, as I expected and have warned about repeatedly, the year over year change in effectuated enrollment is a different story: While effectuated enrollment in January was actually 8.5% higher than January 2025, it has since dropped off rapidly and April 2026 enrollment is actually 4.3% lower than it was a year earlier...that's a swing of 14,000 more plan selections to over 15,000 fewer people actually enrolled.
Overall, average monthly effectuated enrollment is still up slightly for the first four months, but only by around 1,600 people.
Covered California, the state's ACA exchange, has published effectuated enrollment data for January & February 2026, so it's time to dig in and see what this might say about national trends.
Officially, Qualified Health Plan (QHP) selections during Open Enrollment were only 2.6% lower than they were in 2025. However, as I expected and have warned about repeatedly, the year over year drop in effectuated enrollment was higher than that in January (down to 1,839,000, a 2.8% drop y/y), and the gap more than tripled in February:
