Around 486,000 Pennsylvanians enrolled in Pennie coverage during the 2026 Open Enrollment period compared to 496,000 enrollees for 2025. Enrollment in 2026 went from being 11% higher at the start of Open Enrollment to being 2% lower by the end when compared to 2025.

Roughly 79,500 Pennsylvanians enrolled in coverage through Pennie for the first time, but it was clear that costs remained a barrier with new enrollment being 12% lower than last year. Nearly 18% of enrollees dropped coverage altogether. Terminations were highest among older and rural Pennsylvanians and those with incomes just above Medicaid or above the new income cliff. Fifteen of the top 20 counties, based on proportional disenrollment, were rural counties. Many in these areas relied on the enhanced premium tax credits (EPTCs), which Congress did not extend by the December 31 deadline, to afford higher premiums.

The expiration of EPTCs raised costs, leading to 85,000 people leaving Pennie coverage. Around 33,000 more Pennsylvanians enrolled in bronze plans this year compared to last year, a 30% increase. While the numbers do not seem stark in contrast at this point, typically enrollment drops after the first three months of the year due to consumers not being able to afford the plan they chose.

Check out Pennie by the numbers. 

From Becker’s Hospital Review

Does talking about Value-Based Care remind you of alphabet soup? The Rural Health Value team is pleased to share a new resource – a Glossary of Value-Based Care Terms. This compilation of key terms with brief definitions will help readers understand the vocabulary and terminology used in value‑based care and payment.

Related resources on the Rural Health Value website:

• Value-Based Care Assessment Tool
  Assesses an organization’s value-based care capacities and readiness for value-based care using this tool from Rural Health Value.
• Introduction to Rural Clinically Integrated Networks (CINs)
  This Rural Health Value topic brief defines CINs, describes common CIN characteristics, and explores the unique value-based care advantages a rural CIN may bring to its members.

Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org. For more information, contact Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu.

The Pennsylvania State Data Center’s latest brief explores trends in educational attainment across Pennsylvania using the most recent data available from the release of the 2020-2024 American Community Survey (ACS) 5-Year Estimates. The brief examines how the share of adults with a bachelor’s degree or higher has changed across Pennsylvania’s counties, and how the distribution of degrees by field (e.g., Education, Science and Engineering, and Arts and Humanities) has shifted over time.

Other U.S. Census Bureau Reports

U.S. Decreases in Net International Migration Slowed Population Growth Across the Country

Population growth slowed to 0.5% between 2024 and 2025, which is the slowest rate since the COVID-19 pandemic. The slowdown was driven by a historic decline in net international migration. Read more here.

Census Bureau Data Show Large Gains in Educational Attainment in Metropolitan and Micropolitan Statistical Areas

Significant gains in educational attainment were made across the nation, with approximately 89% of metro areas experiencing an increase in the share of adults age 25 and over with a bachelor’s degree or higher from the 2015-2019 ACS to the 2020-2024 ACS. Read more here.

Renters in 20% of U.S. Counties Paid More in 2020-2024 than in Previous Five Years

Median monthly rent rose $100 to $1,413 nationally, with rents increasing in nearly twice as many counties as they decreased. Homeowners’ median monthly mortgage costs remained essentially unchanged at $1,963. Read more here.

A survey finds that about half of respondent firms in the Third Federal Reserve District use generative artificial intelligence (AI) tools, yet its impact on labor demand among many of these firms remains limited.

Here’s what the Philadelphia Fed survey of businesses in Delaware, southern New Jersey, and eastern and central Pennsylvania found:

• Nearly 75 percent of the respondents use some form of AI, with about half using generative AI.
• About 70 percent of the firms using generative AI said it didn’t change their need for workers.
• Seventeen percent of the firms reported that generative AI changed the type of workers needed, not the number.

Read the full report here.

The Pennsylvania Health Care Cost Containment Council’s (PHC4) Financial Analysis 2024 – Rural Hospitals report displays information specific to Pennsylvania general acute care (GAC) hospitals located in rural counties. Supplementary to PHC4’s Financial Analysis, this is the second report in this new annual series, offering succinct data to support all who rely on rural health care in the Commonwealth.

Rural hospitals, which comprise 41% of Pennsylvania’s statewide total number of GAC hospitals, exhibit distinct financial characteristics. This analysis focuses on the 63 GAC hospitals located in rural areas in fiscal year 2024 (FY24). Of these 63 rural hospitals, 22 (35%) reported operating losses during FY24 based on their operating margins. The average net patient revenue for these hospitals operating at a loss was $80 million in FY24.

The key factors that may contribute to the financial challenges at rural hospitals include:

• Decreased Reimbursements: Reduced payments from government programs such as Medicare and Medicaid placing significant financial pressure on rural hospitals.
• Aging Populations: Rural communities often have older populations, typically requiring more complex and costly medical care.
• Lower Patient Volume: Serving smaller populations limits revenue potential, making it harder for rural hospitals to cover operating expenses.
• Higher Operating Costs: Geographic and logistical challenges—such as transportation, staffing shortages, and maintaining specialized services—contribute to elevated costs.
• Uncompensated Care: Rural hospitals face a growing burden of uncompensated care, including patient bad debt and charity care.

PHC4 strives to ensure Pennsylvanians are armed with publicly available, fact-based, health care information and plans to continuously enrich its reporting and the resources it develops to bring value to communities across the Commonwealth.  PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered. For more information, visit phc4.org or access the report here.

PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.  

 A new brief, Use of Preventive Services by Rurality, Disability Status, and Health Insurance, from the University of Minnesota Rural Health Research Center examines rates of utilizing two types of preventive care, including routine physicals, and flu vaccination)by rural-urban location, disability status, and health insurance type.

Through the Data Requests department, the Pennsylvania Health Care Cost Containment Council (PHC4) offers custom and standard data files to help you obtain and analyze the health care data you need for health care studies or projects. Our analysts will work with you to meet your comprehensive health care data needs.

Visit the Purchase Customized Data section of PHC4’s website for more information about our data and services, or contact JoAnne Nelson, Director of Financial Analysis and Data Requests at specialrequests@phc4.org.

The Centers for Medicare & Medicaid Services has released its latest Medicaid and CHIP Beneficiary Profile, offering valuable insights for health policy professionals and those serving Medicaid populations.

Key findings include:

• Medicaid covered 41.6% of all U.S. births in 2023, with some states reaching as high as 67.9%
• Children represent 35.9% of all Medicaid beneficiaries nationally, with certain states enrolling up to 75% children
• More than one-third of Medicaid/CHIP households also receive SNAP benefits, underscoring the opportunity for Medicaid and SNAP coordination to smooth the consumer experience and ensure efficient use of taxpayer dollars.

Read the full profile.