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Obamacare Enrollment by State: Most Enrollees Live in Republican Areas

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Obamacare Enrollment by State: Most Enrollees Live in Republican Areas

More than 23 million Americans are currently enrolled in Obamacare plans, and nearly all of them will face higher health care costs next year if extra federal funding for subsidies expires, as scheduled, on Dec. 31.

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Share of population enrolled in Obamacare plans

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Source: KFF

Note: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming have not adopted the Affordable Care Act’s Medicaid expansion.

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The New York Times

Democrats in Congress are withholding their votes on a government spending bill to demand that Republicans extend these subsidies, which lower the cost of insurance for people who buy their own health care coverage in marketplaces established by the Affordable Care Act. Since Congress introduced the extra funding in 2021, enrollment has doubled.

These Americans live nearly everywhere in the country, but their numbers are especially concentrated in a handful of red states whose governments have declined to expand Medicaid programs to cover poor, childless adults.

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Fifty-seven percent of people with this type of insurance live in Republican congressional districts.

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Obamacare enrollment rates, by congressional district

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Source: KFF

The New York Times

The difference is driven by extra enrollment in states that hadn’t expanded Medicaid since the Affordable Care Act encouraged states to do so in 2014. Obamacare was designed to cover the poorest Americans with Medicaid and then offer subsidies for people who earned more. There is a small share of the income distribution that overlaps; those people are eligible for Medicaid where it is available, and subsidies where it is not. As a result, more low-income Americans are eligible for subsidies in states that don’t offer Medicaid to all poor adults.

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Since subsidies became more generous in 2021, overall enrollment has more than tripled in six red states: Texas, Louisiana, Mississippi, Tennessee, Georgia and West Virginia. Of that group, only West Virginia expanded Medicaid.

Obamacare coverage has become especially widespread in south Florida, where there is a large concentration of low-wage workers and early retirees.

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Most of the congressional districts with the highest enrollments are in states that Trump won in the presidential election, but not all are represented by Republicans in Congress.

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Districts with the highest Obamacare enrollment rates

Note: Table only includes districts with rates 15 percent or higher. Margin of victory not shown for representatives who ran uncontested or faced another member of the same party on the November ballot.

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The New York Times

Americans with relatively low incomes make up the largest group of enrollees by far. Nearly half of consumers nationwide earn less than 150 percent of the federal poverty level, around $24,000 for a single person in most states or around $48,000 for a family of four. These people tend to work in low-wage jobs that don’t offer health insurance, have part-time employment, or are freelancers who work gig jobs.

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The extra subsidies are especially generous for this group. As long as they choose one of the two lowest-cost plans in their market, they don’t have to make any monthly payments for their premiums. Critics of the subsidies think these are so generous for this group that they have invited fraud. If the subsidies expire, the share of premiums for this group will go up to around $27 to $82 a month.

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Obamacare enrollment, by income range

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Source: KFF

Note: Two groups, the group of people below the federal poverty level and the group labeled as “Unknown” in the data, were excluded from the table. They make up 2.2% and 3.8% of total enrollees.

The New York Times

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Americans who earn more than 400 percent of the poverty level, around $63,000 for a single person in most states or $129,000 for a family of four, make up a much smaller share of the market, around 7 percent. This group tends to include people who are self-employed or who work for small businesses, and early retirees — all of whom lack work-based options.

In dollar terms, the expiring subsidies will make the biggest difference for this group. With the extra subsidies, their payments are capped at 8.5 percent of their income. Without action, they will have to pay the full cost of their insurance next year, more than $2,000 a month for older people in the most expensive markets.

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Some conservative critics of the extra subsidies argue this group earns enough that they should be expected to pay their insurance premiums without help.

Without the extra subsidies, analysts expect that millions of Americans enrolled in Obamacare will drop their insurance coverage or face higher prices. The Congressional Budget Office estimates that around two million more people will become uninsured next year without the extra financial help, and the number could rise to 3.8 million by 2035. Other analyses have estimated even larger reductions in coverage.

Exactly who will become uninsured is difficult to know. But Cynthia Cox, a vice president at KFF, a health care research group, said the losses were most likely to occur in the places where signups had risen the most since the extra subsidies became law in 2021.

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Change in enrollment from 2020 to 2025

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Source: KFF

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Note: Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming have not adopted the Affordable Care Act’s Medicaid expansion. The margin of victory in the presidential election in 2024 is shown.

The New York Times

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Video: Erika Kirk’s Message for Women at Turning Point USA

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Video: Erika Kirk’s Message for Women at Turning Point USA

new video loaded: Erika Kirk’s Message for Women at Turning Point USA

Our reporter Vivian Yee details what she saw at this year’s Turning Point USA Women’s Leadership Summit in San Antonio.

By Vivian Yee, Christina Shaman, Lauren Pruitt, James Surdam and Melanie Bencosme

June 18, 2026

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New poll reveals where Americans stand after Trump agreement with Iran

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New poll reveals where Americans stand after Trump agreement with Iran

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FIRST ON FOX: Americans are nearly evenly split between favoring Iranian regime change and a negotiated U.S. settlement with Iran, according to a new survey. 

Some 39% of respondents favor a negotiated settlement where Iran’s current government remains in place, with verifiable limits on its nuclear and missile programs, according to the findings of the Reagan Institute Summer Survey, while 36% favor replacing Iran’s current government with one more favorable to the U.S. 

Another 16% favor a weakened regime where the current government stays in place but is significantly diminished militarily and economically, and 8% responded that they don’t know. 

The findings underscore the political challenge facing President Donald Trump as his administration pursues a newly signed memorandum of understanding with Iran. While the agreement seeks to curb Iran’s nuclear ambitions through negotiations, Americans remain divided over the ultimate objective of U.S. policy toward the Islamic Republic.

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Americans are nearly evenly split between favoring Iranian regime change and a negotiated U.S. settlement with Iran, according to a new survey.  (Mandel NGAN / AFP via Getty Images)

AMERICANS AGREE WITH TRUMP THAT IRAN POSES THREAT TO UNITED STATES: POLL

Republicans who responded to the survey favored replacing Iran’s government by a 2-to-1 margin over a diplomatic deal. 

Republicans were far more likely than Democrats to favor a more aggressive outcome in Iran. Half of Republican respondents said they would prefer to see Iran’s current government replaced with one more favorable to the United States, compared to 25% who said they would favor a negotiated settlement that leaves the regime in place in exchange for verifiable limits on its nuclear and missile programs.

The findings were nearly identical among self-identified MAGA Republicans, 51% of whom favored regime change while 25% backed a negotiated settlement.

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SHARP PARTISAN DIVIDE EMERGES OVER IRAN STRIKE, TRUMP’S STRATEGY: POLLS

Democrats, meanwhile, largely favored diplomacy. A majority, 52%, said they would prefer a negotiated settlement with Iran’s current government, while 25% favored regime change. Another 14% favored leaving the regime in place but significantly weakened militarily and economically.

The Reagan Institute Summer Survey was conducted May 26 through June 3 among 1,555 respondents nationwide and carries a margin of error of plus or minus 2.5 percentage points. The survey used a mixed-mode methodology that included live telephone interviews, an online panel and text-to-web responses.

Smoke rises over Tehran following an explosion amid ongoing U.S. and Israeli military strikes on Iranian targets on March 2, 2026. (Majid Saeedi/Getty Images)

The findings underscore the political challenge facing President Donald Trump as his administration pursues a newly signed memorandum of understanding with Iran. (Hamid FOROUTAN / ISNA / AFP via Getty Images)

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Republicans were far more likely than Democrats to favor a more aggressive outcome in Iran.  (Pool via WANA/Reuters)

To better reflect the U.S. population, the results were weighted using demographic benchmarks from the U.S. Census Bureau’s 2023 American Community Survey, including age, gender, race, region and education levels. The poll also included an oversample of 331 MAGA Republicans under age 30, a group with a margin of error of plus or minus 5 percentage points.

The Reagan Institute is a Washington-based policy organization that advocates the Reagan foreign-policy tradition of “peace through strength” and sustained American leadership abroad.

The findings come as Trump has defended a newly signed memorandum of understanding with Iran as a way to reduce tensions and create a pathway toward a broader agreement addressing Tehran’s nuclear program.

The memorandum establishes a 60-day negotiating period during which the United States and Iran will attempt to reach a more comprehensive deal. The agreement also includes provisions aimed at restoring commercial shipping through the Strait of Hormuz and provides limited sanctions waivers tied to continued negotiations. Several of the most contentious issues, including the long-term future of Iran’s nuclear program, are expected to be addressed in subsequent talks.

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Trump has described the arrangement as a means of avoiding a wider conflict while pursuing what he called a “great settlement” with Tehran. He has also argued that the agreement could help stabilize energy markets by reopening the Strait of Hormuz, a critical global shipping route, while creating an opportunity to negotiate additional restrictions on Iran’s nuclear activities.

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The president added that he agreed to a settlement to avoid “economic catastrophe.” 

“I didn’t want to see economic catastrophe. If you kept this going, that could have happened,” he told reporters at the G7 Summit in France. 

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Long list of U.S. concessions to Iran raises specter of a ‘lost war’

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Long list of U.S. concessions to Iran raises specter of a ‘lost war’

The White House pushed back Thursday against growing bipartisan criticism of a negotiated settlement to the war with Iran, arguing its concessions to the Islamic Republic were contingent on its conduct and essential to securing peace.

The administration’s defensive posture came as details of the framework agreement, known as a memorandum of understanding, were finally shared with the public, revealing a raft of compromises with Tehran long opposed by Republicans.

Vice President JD Vance, who helped negotiate the deal, told reporters Thursday that the deal was structured to reward Iran for good behavior. But the text of the agreement suggests otherwise.

The Trump administration agreed to release billions of dollars in Iranian assets that were frozen and restricted by the United States “upon the implementation” of the memorandum — before any further actions are taken or additional negotiations begin. The president will issue sanctions waivers on Iranian oil, allowing Tehran to resume trading its most valuable export and breaking with decades of policy. And to facilitate that trade, boosting Tehran’s revenues, Trump agreed to immediately end a U.S. naval blockade of Iranian ports.

Still more concessions were offered to the Iranians, including a commitment by the U.S. administration to establish a fund of “at least $300 billion for the reconstruction and economic development of the Islamic Republic” — in effect providing reparations for the war Trump started.

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“All required licenses, waivers and permissions needed for the relevant financial transactions will be granted by the United States of America,” the memorandum reads.

Taken together, the document reads as a stunning reversal of U.S. policy toward Iran after decades of concern across administrations in Washington — including throughout Trump’s two terms — that the Islamic Republic represents the nation’s greatest security threats as the world’s largest state sponsor of terrorism.

Criticism from Republican senators, in particular, has been sharp and swift.

Sen. Roger Wicker (R-Miss.), chairman of the Senate Armed Services Committee, said the $300-billion fund “would make Iran’s payoff under President Obama’s 2015 deal look like a pittance by comparison.” And Sen. Ted Cruz (R-Texas) accused the Trump administration of giving Iran money it would use to kill Americans.

“History demonstrates that giving billions of dollars to theocratic lunatics who want to murder us is an exceptionally bad idea, and I think, unfortunately, the president is receiving some really bad advice on this deal,” Cruz said. “I don’t want to see us send a penny to the ayatollah. And I hope that we don’t.”

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The Obama-era deal, known as the Joint Comprehensive Plan of Action, included structured sanctions relief for Iran in exchange for concrete and verifiable steps by Tehran to dismantle much of its nuclear program — a framework that Republicans broadly criticized at the time.

By contrast, Trump’s agreement commits the United States to pursuing economic relief for Iran while providing no clarity about the future of Iran’s nuclear program — the very issue Trump cited as the rationale for launching the war.

The memorandum includes a pledge by Iran to never purchase or construct nuclear weapons — a vow the Islamic Republic has made multiple times before, including by signing the Nuclear Non-Proliferation Treaty, in a religious edict issued by the late supreme leader and in the Obama-era nuclear accord.

Vice President JD Vance speaks to reporters at the White House on June 18, 2026.

(Manuel Balce Ceneta / Associated Press)

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Detailed negotiations over Iran’s nuclear program — including whether Tehran could continue domestic uranium enrichment, at what level, and under what monitoring regime — were left for another day.

For more than a decade, the U.S. intelligence community has assessed that Iran sought a threshold nuclear capability, securing the strategic advantages of a nuclear power without incurring the costs of openly pursuing a bomb.

The agreement does include a commitment by Iran to do its “best” to bring commercial shipping traffic through the Strait of Hormuz, a vital international waterway, back to prewar levels. But critics of the president said he had to make deep, historic concessions just to secure a status quo ante upended by the war he started. And in the document, Tehran agreed to refrain from imposing a toll on ships transiting the strait for only a 60-day period.

“Unless you were homeschooled by a day drinker, no one’s confident that Iran is going to do anything,” Sen. John Kennedy, a Republican from Louisiana, told reporters this week.

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Sen. Bill Cassidy, Kennedy’s Republican counterpart from Louisiana, called the deal “the worst foreign policy blunder in decades” that would have President Reagan “rolling over in his grave.”

“Iran’s nuclear ambitions were not curbed, and they have learned that threatening the Strait of Hormuz works and will undoubtedly leverage it in the future. Now, Iran gets to build brand-new infrastructure under this deal,” Cassidy said.

“Before the war, the strait was open, Iran was being crushed by sanctions, and 13 service members were still alive,” he added. “Now, 13 Americans are dead, families have paid billions at the pump, sanctions will be lifted, and the bombing has stopped.”

Despite mounting criticism, Trump put his signature to the memorandum on Wednesday night while attending a dinner with the French president in Versailles, a palace infamous for hosting a treaty signing that disgraced Germany at the end of the First World War.

He defended the agreement while in Europe and suggested further concessions might be forthcoming, including recognition of Iran’s claimed right to enrich uranium and a new willingness to tolerate its continued ballistic missile development — another program that Trump had vowed to eliminate as a central war aim.

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“He took America to war — killing 13 soldiers, thousands of Iranian civilians and costing taxpayers $60 billion — to get rid of Iran’s missile program. And now that he’s lost the war, he pretends like it’s no big deal,” said Sen. Chris Murphy, a Democrat from Connecticut.

“Just unforgivable,” he added. “What a charlatan.”

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