Charles Gaba's blog

via Covered California's Open Enrollment Dashboard, as of December 27th:

• New enrollments: 137,958
• Active renewals: 479,358
• Passive Autorenewals: 1,318,779
• Total: 1,936,095

As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which isn't until New Year's Eve in California).

More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.

In California, those come to 617,316 combined.

As of the same point last year (actually 1 day more; the data from last year is as of 12/28), Covered CA was reporting:

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

September 2025 Key Findings

Medicaid and CHIP Enrollment

• In September 2025, 77.1 million individuals were enrolled in Medicaid and CHIP.
• 69.8 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 40.3 million adults were enrolled in Medicaid, and there were 36.7 million Medicaid child and CHIP enrollees.

Total Medicaid/CHIP enrollment in September 2025 of ~77.1 million dropped about 0.9% from July 2025, or by around 700,000 people.

Originally posted 12/19/25

Since we're past the initial December 15th Open Enrollment Deadline for coverage starting January 1st in most states and since there's been several enrollment deadline extensions announced by various states (including two more today), I figured this would be a good time to post a completely updated rundown of just what the remaining deadlines are for every state as well as what your options are if you miss them.

This is basically a standalone version of the first section of my annual Open Enrollment Guide; I hope that separating it out will make it less overwhelming.

IDAHO: December 15th was the only deadline for 2026 coverage. If you missed it, you're pretty much out of luck unless you qualify for one of the following exceptions:

Long ago in a galaxy far, far away, during the first batcrap insane 2014 Open Enrollment Period, a common refrain from Republicans looking to attack the newly-ramping up healthcare law was to demand "BUT HOW MANY HAVE PAID???"

The gist of the attack on the ACA was that after the worst of the ugly technical problems experienced by HealthCare.Gov and many of the state-based exchange websites were resolved, there was indeed a rush of backed-up demand to enroll in healthcare coverage by millions of people, but that just because a lot of people signed up for insurance coverage via the exchanges, that didn't necessarily mean they were actually enrolled in that policy.

The reason for this, of course, is that you have to actually pay your first monthly premium in order to have your enrollment "effectuated" (i.e., put into effect).

via Covered California's Open Enrollment Dashboard, as of December 20th:

• New enrollments: 123,461
• Active renewals: 460,670
• Passive Autorenewals: 1,355,397
• Total: 1,939,528

As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which was December 15th in most states, but not until 12/31 in CA, IL, MD, NV, NJ, NM, PA, RI & VA).

More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.

In California, those come to 584,131 combined. This also means that only 25% of current enrollees had actively re-enrolled as of 12/20.

As of the same point last year (actually 1 day more; the data from last year is as of 12/21), Covered CA was reporting:

As of March 2025, around 72,000 Nebraska residents were enrolled in Medicaid via the ACA's expansion of the program.

Last summer, after Congressional Republicans passed their Big Ugly Bill, I warned people against assuming that the gutting of Medicaid wouldn't hit until after the 2026 midterms:

Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...

Republicans know how unpopular all this will be. So they’ve structured the bill so the tax cuts land immediately, while many of the Medicaid cuts get going in 2027 and 2028. That’s meant to spare them in the midterms.

Just before shutting down for Christmas, Trump Regime CMS Administrator Dr. Oz announced that...

Quick ACA Update: More than 15.6 million Americans have enrolled in a plan on the federally run exchanges so far — compared to roughly 16 million Americans last year.

Notably, this small drop follows several important CMS actions over the past year to combat fraudulent and improper enrollments, which have already removed more than enough people from premium subsidies who are covered elsewhere to account for the modest enrollment change. That said, there is a politically motivated lawsuit that has paused critical actions to make sure Biden-era improper enrollments are fully knocked out.

IMPORTANT NOTE: For those who need insurance and have not already signed up — go to HealthCare.Gov to see if you qualify and what types of plans you can get. Most Americans can access a plan for $21 a month!