ACA signups more than doubled since the enhanced premium tax credits went into effect, from 11.4 million in 2020 to 24.3 million this year. Without that enhanced premium assistance, enrollment will drop substantially.

Absolutely. But, overhead in Medicare Advantage -- which now covers over half of Medicare beneficiaries -- is much higher than that given the role of private insurers.

I haven’t looked at Virginia’s marketplace. But I wonder if they’re showing the tax credits that would still be in place if the enhanced credits expire. There would still be tax credits, just much smaller ones.

The underlying premium increases are higher in the federal marketplace than in state-based marketplaces. That will lead to a bigger increase for people with incomes over 400% of the poverty level. The increase in out-of-pocket premiums for lower income people will be similar.

The 26% increase in benchmark premiums is driven in part by health care cost increases. Also by an expected exodus of healthier than average people assuming enhanced tax credits expire. It may also be that some lower priced plans are exiting the market. And that insurers are pricing for uncertainty.