Recent legislative changes, coupled with the anticipated expiration of ⁤enhanced⁢ premium tax credits, are projected to significantly‍ increase the number of uninsured Americans.‌ Analysis indicates a potential rise of over 14 million uninsured individuals ⁣by 2034, building on a base increase of 10⁢ million due to the new legislation alone.

This analysis details the state-by-state impact of these changes,presenting the increase in uninsured ‌as a percentage of each ‍state’s population. Two maps illustrate⁤ the effects: one ⁢showing the impact of the ‍legislation, and another combining that with the expiration of ⁤the ACA’s enhanced premium tax credits. The​ analysis acknowledges inherent uncertainty in predicting ‌state-level responses to‍ policy changes, presenting a range of potential enrollment effects for each state.

Key findings include:

• National Impact: ⁤A projected increase in the uninsured rate nationally, exceeding 14 million individuals by 2034 when factoring in both the legislation and the expiration of tax credits.
• State-Level Variation: 20 states and the ​District of Columbia‌ are expected to see uninsured rate increases of 3⁢ percentage‌ points or more due to the legislation alone.
• Largest Increases in Uninsured Numbers: California and New York are projected to experience ⁢the largest ‌absolute increases in uninsured ⁤individuals (1.6 million and 860,000 respectively).
• Combined Effects: Louisiana, Florida, and Arizona are anticipated to experience the‍ most considerable increases in ‍uninsured rates when considering both ⁤the legislation and​ the tax credit expiration – potentially exceeding 5 percentage points.

the states ‍with the largest growth in ACA Marketplace enrollment since 2020 – Texas, Florida,‌ and Georgia – ⁢are ​also among‍ those projected to see significant increases in the uninsured population.

Further ⁣increases in the number of uninsured are​ anticipated due to the recently finalized ACA Marketplace Integrity and​ Affordability rule, though precise estimates from the Congressional Budget Office are not yet available. Initial ⁣estimates suggest ⁣this⁣ rule ‌could lead to ⁣an increase of 725,000 to 1.8 million uninsured individuals in 2026 alone.

Methodology: this analysis utilizes estimates from the Congressional⁤ Budget Office, allocating increases in ‌the uninsured population based⁢ on the ⁢projected impact of changes ⁢to Medicaid and‍ the Affordable care​ Act exchanges.⁢ State-level allocations for Medicaid changes‍ are based on prior KFF analysis of federal spending reductions.