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.