Center for Advancing Health Services Policy & Economics Research
@cahsperiph.bsky.social
Center for Advancing Health Services Policy & Economics Research, Washington University in St. Louis.
ACA Marketplace (Obamacare) signups drop 1.2 million (-4.9%) in 2026, as consumers face increase in premiums
ACA marketplace enrollment down -12% in Missouri, over 51,000 in 2026
siftingandwinnowing.substack.com/p/aca-signup...
ACA marketplace enrollment down -12% in Missouri, over 51,000 in 2026
siftingandwinnowing.substack.com/p/aca-signup...
January 29, 2026 at 10:59 AM
ACA Marketplace (Obamacare) signups drop 1.2 million (-4.9%) in 2026, as consumers face increase in premiums
ACA marketplace enrollment down -12% in Missouri, over 51,000 in 2026
siftingandwinnowing.substack.com/p/aca-signup...
ACA marketplace enrollment down -12% in Missouri, over 51,000 in 2026
siftingandwinnowing.substack.com/p/aca-signup...
Missouri Medicaid Update:
Applications down 11% in 2025 during open enrollment period; but approvals up 26%
Latest report may reflect improved processing times and drop in pending applications
siftingandwinnowing.substack.com/p/missouri-m...
Applications down 11% in 2025 during open enrollment period; but approvals up 26%
Latest report may reflect improved processing times and drop in pending applications
siftingandwinnowing.substack.com/p/missouri-m...
January 24, 2026 at 6:57 PM
Missouri Medicaid Update:
Applications down 11% in 2025 during open enrollment period; but approvals up 26%
Latest report may reflect improved processing times and drop in pending applications
siftingandwinnowing.substack.com/p/missouri-m...
Applications down 11% in 2025 during open enrollment period; but approvals up 26%
Latest report may reflect improved processing times and drop in pending applications
siftingandwinnowing.substack.com/p/missouri-m...
Missouri Medicaid Financing Update: Medicaid expansion completely funded by federal funds to date
Medicaid expansion completely funded by federal funds: matching funds and over $1 billion MO received and put into a reserve. But reserves will be exhausted in 2026 open.substack.com/pub/siftinga...
Medicaid expansion completely funded by federal funds: matching funds and over $1 billion MO received and put into a reserve. But reserves will be exhausted in 2026 open.substack.com/pub/siftinga...
January 15, 2026 at 1:00 PM
Missouri Medicaid Financing Update: Medicaid expansion completely funded by federal funds to date
Medicaid expansion completely funded by federal funds: matching funds and over $1 billion MO received and put into a reserve. But reserves will be exhausted in 2026 open.substack.com/pub/siftinga...
Medicaid expansion completely funded by federal funds: matching funds and over $1 billion MO received and put into a reserve. But reserves will be exhausted in 2026 open.substack.com/pub/siftinga...
CMS reports that over 833,810 fewer people have signed up for ACA marketplace (“Obamacare”) plans.
In 11 states (including Missouri) signups for plans dropped by more than 10%. In MO, signups dropped 11.3% (-46,054), from 407,782 in 2025 to 361,728 in 2026. See
open.substack.com/pub/siftinga...
In 11 states (including Missouri) signups for plans dropped by more than 10%. In MO, signups dropped 11.3% (-46,054), from 407,782 in 2025 to 361,728 in 2026. See
open.substack.com/pub/siftinga...
January 13, 2026 at 2:33 PM
CMS reports that over 833,810 fewer people have signed up for ACA marketplace (“Obamacare”) plans.
In 11 states (including Missouri) signups for plans dropped by more than 10%. In MO, signups dropped 11.3% (-46,054), from 407,782 in 2025 to 361,728 in 2026. See
open.substack.com/pub/siftinga...
In 11 states (including Missouri) signups for plans dropped by more than 10%. In MO, signups dropped 11.3% (-46,054), from 407,782 in 2025 to 361,728 in 2026. See
open.substack.com/pub/siftinga...
Missouri Medicaid 2025 Update: Annual Summary
Medicaid enrollment stable (up 0.2%), but stability hides significant underlying changes in categories of recipients
Open enrollment in progress, applications up 29% in Nov but pending applications down
siftingandwinnowing.substack.com/p/missouri-m...
Medicaid enrollment stable (up 0.2%), but stability hides significant underlying changes in categories of recipients
Open enrollment in progress, applications up 29% in Nov but pending applications down
siftingandwinnowing.substack.com/p/missouri-m...
January 8, 2026 at 11:44 AM
Missouri Medicaid 2025 Update: Annual Summary
Medicaid enrollment stable (up 0.2%), but stability hides significant underlying changes in categories of recipients
Open enrollment in progress, applications up 29% in Nov but pending applications down
siftingandwinnowing.substack.com/p/missouri-m...
Medicaid enrollment stable (up 0.2%), but stability hides significant underlying changes in categories of recipients
Open enrollment in progress, applications up 29% in Nov but pending applications down
siftingandwinnowing.substack.com/p/missouri-m...
Updated:
MISSOURI Medicaid DASHBOARD
with NOV 2025 data on enrollment, applications, managed care
First report after open enrollment started; applications up but below 2024 levels. Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with NOV 2025 data on enrollment, applications, managed care
First report after open enrollment started; applications up but below 2024 levels. Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
December 24, 2025 at 2:50 AM
Updated:
MISSOURI Medicaid DASHBOARD
with NOV 2025 data on enrollment, applications, managed care
First report after open enrollment started; applications up but below 2024 levels. Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with NOV 2025 data on enrollment, applications, managed care
First report after open enrollment started; applications up but below 2024 levels. Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
Missouri Medicaid November 2025 Update:
First Report on Open Enrollment
Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...
First Report on Open Enrollment
Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...
December 20, 2025 at 7:00 PM
Missouri Medicaid November 2025 Update:
First Report on Open Enrollment
Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...
First Report on Open Enrollment
Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...
First ACA Marketplace Snapshot Report for 2026:
Mixed and confusing results?
New consumers down -3.9%; existing selections up 9.9%.
In Missouri, existing selections down 6.6%
timothymcbride.substack.com/p/first-mark...
Mixed and confusing results?
New consumers down -3.9%; existing selections up 9.9%.
In Missouri, existing selections down 6.6%
timothymcbride.substack.com/p/first-mark...
December 10, 2025 at 10:54 AM
First ACA Marketplace Snapshot Report for 2026:
Mixed and confusing results?
New consumers down -3.9%; existing selections up 9.9%.
In Missouri, existing selections down 6.6%
timothymcbride.substack.com/p/first-mark...
Mixed and confusing results?
New consumers down -3.9%; existing selections up 9.9%.
In Missouri, existing selections down 6.6%
timothymcbride.substack.com/p/first-mark...
October 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social
open.substack.com/pub/timothym...
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social
open.substack.com/pub/timothym...
December 6, 2025 at 3:41 PM
October 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social
open.substack.com/pub/timothym...
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social
open.substack.com/pub/timothym...
October 2025 MO Medicaid update: pending applications drop considerably
"significant drop in number of pending applications...70% drop in pending applications from July to October 2025...average days to complete application dropped from 40 to 21 days"
timothymcbride.substack.com/p/october-20...
"significant drop in number of pending applications...70% drop in pending applications from July to October 2025...average days to complete application dropped from 40 to 21 days"
timothymcbride.substack.com/p/october-20...
December 5, 2025 at 11:30 AM
October 2025 MO Medicaid update: pending applications drop considerably
"significant drop in number of pending applications...70% drop in pending applications from July to October 2025...average days to complete application dropped from 40 to 21 days"
timothymcbride.substack.com/p/october-20...
"significant drop in number of pending applications...70% drop in pending applications from July to October 2025...average days to complete application dropped from 40 to 21 days"
timothymcbride.substack.com/p/october-20...
Total enrollment MO Medicaid program rose slightly in Oct but there are shifts in enrollment
Falling:
custodial adults (-20%)
disabled (-13%)
children (-7%),
Rising:
expansion group (+9%)
pregnant women (+31%)
elderly (+5%)
since unwinding
timothymcbride.substack.com/p/october-20...
Falling:
custodial adults (-20%)
disabled (-13%)
children (-7%),
Rising:
expansion group (+9%)
pregnant women (+31%)
elderly (+5%)
since unwinding
timothymcbride.substack.com/p/october-20...
December 5, 2025 at 11:26 AM
Total enrollment MO Medicaid program rose slightly in Oct but there are shifts in enrollment
Falling:
custodial adults (-20%)
disabled (-13%)
children (-7%),
Rising:
expansion group (+9%)
pregnant women (+31%)
elderly (+5%)
since unwinding
timothymcbride.substack.com/p/october-20...
Falling:
custodial adults (-20%)
disabled (-13%)
children (-7%),
Rising:
expansion group (+9%)
pregnant women (+31%)
elderly (+5%)
since unwinding
timothymcbride.substack.com/p/october-20...
Updated:
MISSOURI Medicaid DASHBOARD
with OCTOBER 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment steady at about 1.27 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with OCTOBER 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment steady at about 1.27 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
December 3, 2025 at 9:39 PM
Updated:
MISSOURI Medicaid DASHBOARD
with OCTOBER 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment steady at about 1.27 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with OCTOBER 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment steady at about 1.27 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
Read @cahsperiph.bsky.social policy brief cited here at
cahsper.wustl.edu/items/change...
To see the data in a dashboard or maps go here:
cahsper.wustl.edu/impact/medic...
cahsper.wustl.edu/items/change...
To see the data in a dashboard or maps go here:
cahsper.wustl.edu/impact/medic...
November 26, 2025 at 11:03 PM
Read @cahsperiph.bsky.social policy brief cited here at
cahsper.wustl.edu/items/change...
To see the data in a dashboard or maps go here:
cahsper.wustl.edu/impact/medic...
cahsper.wustl.edu/items/change...
To see the data in a dashboard or maps go here:
cahsper.wustl.edu/impact/medic...
Quote from article citing @cahsperiph.bsky.social work:
November 26, 2025 at 10:51 PM
Quote from article citing @cahsperiph.bsky.social work:
Changes in Medicaid and Marketplace Enrollment in Missouri by County, and Rural/Urban Status, 2023-2025
In 2023-2025 Medicaid enrollment fell while Marketplace enrollment grew. New @cahsperiph.bsky.social analysis examines these shifts with implications for 2026
cahsper.wustl.edu/files/2025/1...
In 2023-2025 Medicaid enrollment fell while Marketplace enrollment grew. New @cahsperiph.bsky.social analysis examines these shifts with implications for 2026
cahsper.wustl.edu/files/2025/1...
October 30, 2025 at 9:21 PM
Changes in Medicaid and Marketplace Enrollment in Missouri by County, and Rural/Urban Status, 2023-2025
In 2023-2025 Medicaid enrollment fell while Marketplace enrollment grew. New @cahsperiph.bsky.social analysis examines these shifts with implications for 2026
cahsper.wustl.edu/files/2025/1...
In 2023-2025 Medicaid enrollment fell while Marketplace enrollment grew. New @cahsperiph.bsky.social analysis examines these shifts with implications for 2026
cahsper.wustl.edu/files/2025/1...
September 2025 Update: Missouri Medicaid
For second month in a row Missouri hits peak enrollment in Medicaid expansion category (at 357,654)
@cahsperiph.bsky.social analysis:
timothymcbride.substack.com/p/september-...
For second month in a row Missouri hits peak enrollment in Medicaid expansion category (at 357,654)
@cahsperiph.bsky.social analysis:
timothymcbride.substack.com/p/september-...
October 22, 2025 at 6:26 PM
September 2025 Update: Missouri Medicaid
For second month in a row Missouri hits peak enrollment in Medicaid expansion category (at 357,654)
@cahsperiph.bsky.social analysis:
timothymcbride.substack.com/p/september-...
For second month in a row Missouri hits peak enrollment in Medicaid expansion category (at 357,654)
@cahsperiph.bsky.social analysis:
timothymcbride.substack.com/p/september-...
September 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop
Enrollment in Missouri Medicaid expansion hits peak, pending applications down 27%
Analysis by @cahsperiph.bsky.social
open.substack.com/pub/timothym...
Missouri Medicaid enrollment steady; pending applications drop
Enrollment in Missouri Medicaid expansion hits peak, pending applications down 27%
Analysis by @cahsperiph.bsky.social
open.substack.com/pub/timothym...
October 21, 2025 at 9:12 PM
September 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop
Enrollment in Missouri Medicaid expansion hits peak, pending applications down 27%
Analysis by @cahsperiph.bsky.social
open.substack.com/pub/timothym...
Missouri Medicaid enrollment steady; pending applications drop
Enrollment in Missouri Medicaid expansion hits peak, pending applications down 27%
Analysis by @cahsperiph.bsky.social
open.substack.com/pub/timothym...
CAHSPER Co-Director Karen Joynt Maddox speaking at a great conference on the Business of Health co-sponsored by @theatlantic.com and WashU Olin School.
October 15, 2025 at 3:27 PM
CAHSPER Co-Director Karen Joynt Maddox speaking at a great conference on the Business of Health co-sponsored by @theatlantic.com and WashU Olin School.
At another fabulous event put on by the School of Public Health at WashU, the FARM Food Futures Forum with provocative speakers thinking about transforming food systems to support human and planetary health schoolofpublichealth.washu.edu/farm-food-fu...
October 9, 2025 at 5:13 PM
At another fabulous event put on by the School of Public Health at WashU, the FARM Food Futures Forum with provocative speakers thinking about transforming food systems to support human and planetary health schoolofpublichealth.washu.edu/farm-food-fu...
New search for faculty (all levels, ranks) in the School of Public Health at WashU
Outstanding faculty sought with diverse perspectives, particularly focus on our Innovation Research Networks, rural health; food policy; diabetes.
Also Assoc Deans for Research & Practice
apply.interfolio.com/173629
Outstanding faculty sought with diverse perspectives, particularly focus on our Innovation Research Networks, rural health; food policy; diabetes.
Also Assoc Deans for Research & Practice
apply.interfolio.com/173629
September 28, 2025 at 11:24 PM
New search for faculty (all levels, ranks) in the School of Public Health at WashU
Outstanding faculty sought with diverse perspectives, particularly focus on our Innovation Research Networks, rural health; food policy; diabetes.
Also Assoc Deans for Research & Practice
apply.interfolio.com/173629
Outstanding faculty sought with diverse perspectives, particularly focus on our Innovation Research Networks, rural health; food policy; diabetes.
Also Assoc Deans for Research & Practice
apply.interfolio.com/173629
Policy, Biodiversity, and the Future of Food:
panel led by WashU School of Public Health Dean Sandro Galea
panel led by WashU School of Public Health Dean Sandro Galea
September 23, 2025 at 9:49 PM
Policy, Biodiversity, and the Future of Food:
panel led by WashU School of Public Health Dean Sandro Galea
panel led by WashU School of Public Health Dean Sandro Galea
NEW:
Dashboards show payor mix in Missouri hospitals, 2016-2024 with breakdowns by payors (e.g., private, Medicaid, Medicare)
Center for Advancing Health Services, Policy & Economics Research | Washington University in St. Louis cahsper.wustl.edu/new-dashboar...
Dashboards show payor mix in Missouri hospitals, 2016-2024 with breakdowns by payors (e.g., private, Medicaid, Medicare)
Center for Advancing Health Services, Policy & Economics Research | Washington University in St. Louis cahsper.wustl.edu/new-dashboar...
September 12, 2025 at 6:10 PM
NEW:
Dashboards show payor mix in Missouri hospitals, 2016-2024 with breakdowns by payors (e.g., private, Medicaid, Medicare)
Center for Advancing Health Services, Policy & Economics Research | Washington University in St. Louis cahsper.wustl.edu/new-dashboar...
Dashboards show payor mix in Missouri hospitals, 2016-2024 with breakdowns by payors (e.g., private, Medicaid, Medicare)
Center for Advancing Health Services, Policy & Economics Research | Washington University in St. Louis cahsper.wustl.edu/new-dashboar...
New from RUPRI Health Panel
Rural EMS Regionalization - Opportunities and Policy Considerations
Policy report highlights how regionalized systems can improve care through coordination to share resources, standardized protocols, and dispatch functions.
apps.its.uiowa.edu/dispatch/mes...
Rural EMS Regionalization - Opportunities and Policy Considerations
Policy report highlights how regionalized systems can improve care through coordination to share resources, standardized protocols, and dispatch functions.
apps.its.uiowa.edu/dispatch/mes...
August 26, 2025 at 3:03 PM
New from RUPRI Health Panel
Rural EMS Regionalization - Opportunities and Policy Considerations
Policy report highlights how regionalized systems can improve care through coordination to share resources, standardized protocols, and dispatch functions.
apps.its.uiowa.edu/dispatch/mes...
Rural EMS Regionalization - Opportunities and Policy Considerations
Policy report highlights how regionalized systems can improve care through coordination to share resources, standardized protocols, and dispatch functions.
apps.its.uiowa.edu/dispatch/mes...
Updated:
MISSOURI Medicaid DASHBOARD
with JULY 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment rises slightly to 1.3 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with JULY 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment rises slightly to 1.3 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
August 25, 2025 at 10:59 AM
Updated:
MISSOURI Medicaid DASHBOARD
with JULY 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment rises slightly to 1.3 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
MISSOURI Medicaid DASHBOARD
with JULY 2025 data on enrollment, applications, managed care & geographic distribution
Enrollment rises slightly to 1.3 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...
July 2025 Update:
Missouri Medicaid enrollment up slightly; applications also rising
open.substack.com/pub/timothym...
Analysis by @cahsperiph.bsky.social
Missouri Medicaid enrollment up slightly; applications also rising
open.substack.com/pub/timothym...
Analysis by @cahsperiph.bsky.social
August 22, 2025 at 5:06 PM
July 2025 Update:
Missouri Medicaid enrollment up slightly; applications also rising
open.substack.com/pub/timothym...
Analysis by @cahsperiph.bsky.social
Missouri Medicaid enrollment up slightly; applications also rising
open.substack.com/pub/timothym...
Analysis by @cahsperiph.bsky.social