Health cost increases to hit red states most

More than 23 million Americans are currently enrolled in Affordable Care Act 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.

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 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.

Fifty-