Idaho: (sigh) Exact thing I said was gonna happen...is happening.

Me, 11 days ago:

...Assuming new enrollment continues to only lag slightly behind last year, there could be up to ~4 million new enrollees for 2026, which means total plan selections could potentially hit ~25 million...which would actually break last year's record of 24.3 million.

If this happens (or anything close to it), you can expect the following scenario to play out:

• ...4. Sometime between Christmas & New Year's Eve, millions of people who let themselves be auto-renewed will receive their January premium invoices...often for double, triple, quadruple or more than what they've been paying this year.

• 5. After they finish freaking the fuck out, some of them will use the extra time left in the Open Enrollment Period (most states will have until January 15th) to switch to a different plan starting in February. They'll still owe the January payment, mind you, and the plan they switch to will likely still cost somewhat more and/or have higher out of pocket costs than they do now. Oh, yeah...and the deductible & out of pocket cap will be reset for 11 months instead of 12, so anything they pay towards that in January won't be counted.

• 6. Others will be forced to drop coverage altogether. This is when the bulk of the "several million losing coverage" that the CBO projected will likely happen. Some may be able to cover the absurdly higher premiums for 3-4 months before having to drop coverage entirely, which will dilute the impact in the media.

...The point is that Trump & Congressional Republicans will get their victory lap & "Much Ado About Nothing" talking points out there before #4 - 7 above happen. Watch for it.

Idaho Capital Sun, today (h/t Louise Norris for the link):

Idaho’s health insurance exchange ended open enrollment Monday night, with thousands of Idahoans canceling plans ahead of the expiration of deep federal government subsidies.

Overall, enrollment in health insurance plans on Your Health Idaho rose by 3% this year compared to last year, with more than 120,000 Idahoans enrolled in plans on the state exchange. But the exchange also saw twice as many people — nearly 8,850 — disenroll in health insurance plans, 24% less new enrollments, and more people shifting to cheaper insurance plans, where health care costs are higher.

Your Health Idaho Executive Director Pat Kelly said affordability was a key concern for Idahoans.

“While we’re certainly encouraged by the increase in enrollment, we’re concerned about those that will find the plan they selected unaffordable and cancel coverage,” he told the Idaho Capital Sun in an interview.

In the coming months, Kelly said he expects another 20,000 Idahoans will cancel coverage due to affordability concerns. It’ll likely take until April for enrollment to settle, he said, as Idahoans get a better sense of how their insurance premiums fit in their budget, and as insurance companies can cancel coverage for nonpayment.

Unlike every other state, in which Open Enrollment is still continuing through at least January 15th, December 15th was the final deadline for Idaho residents to enroll in ACA coverage for the entire year (unless they qualify for a Special Enrollment Period).

Total 2025 Open Enrollment QHP selections in Idaho were 117,373, so a 3% increase would be around 121,000. If ~20,000 drop out in the next few months, that would be a ~17% net attrition rate.

For comparison, as of April 2025, ACA exchange enrollment stood at 22.7 million, which was only around a 6.6% net attrition from the 24.3 million who selected plans during Open Enrollment.

Assuming the 20K estimate by the YHI director proves accurate and Idaho proves representative nationally, this would mean:

• Total 2026 OEP QHP selections would be just over 25 million (almost exactly what I speculated about 2 weeks ago), but...

• A good ~4.2 million of those would be forced to drop coverage by April (around 17%)...exactly the same number that the CBO projected last June:

You have requested that CBO compare the effects of a policy that would permanently extend the expanded premium tax credit with the scheduled expiration under current law. Relative to a permanent extension, in CBO’s baseline projections, the expiration of the expanded credit will increase by 4.2 million the number of people without health insurance in 2034.