via MNsure, Minnesota's ACA exchange:

ST. PAUL, Minn. — Minnesotans still shopping for health insurance have just five three days left to choose from a variety of coverage plans through MNsure, Minnesota’s official health insurance marketplace.

Monday, December 15, is the deadline to enroll for coverage starting January 1, 2026. For Minnesotans who sign up December 16 – January 15, 2025, coverage will start on February 1 instead.

Premium costs and finding the right plan are top of mind for Minnesotans shopping for health insurance this year. MNsure helps consumers shop with confidence by only selling regulated plans from licensed insurance companies. MNsure.org offers free, anonymous cost estimates and side-by-side plan comparison. Consumers can filter and sort plan options using our online tools or take advantage of free in-person help to make sifting through options easier.

So, as expected, both the Senate Democrats bill to simply extend the enhanced ACA tax credits for 3 more years and the Senate Republican bill to make everything worse just failed to reach cloture (appropriately enough, they both received the exact same vote counts: 51-48).

Sen. Rand Paul voted against the GOP bill and 4 Republicans voting for the Democrat's bill, including Sen. Josh Hawley, Sen. Lisa Murkowski, Sen. Dan Sullivan & Sen. Susan Collins voting for it. I'm not sure who the missing vote in each was, not that it matters much now.

So, now what?

Well, the House may end up voting on one of their dozen or so bills they've been tossing around, but I wouldn't count on it, and even if one of them passes, it'd be almost certain to fail in the Senate.

With just 4 more days before the initial December 15th deadline to enroll for coverage starting in January, only a weeks' worth of legislative session days before the holiday break, and just 20 days before the enhanced subsidies actually expire on New Year's Eve, it's looking grim.

Originally posted 3/07/19. Original headline: "Trump's CMS dusts off the old "Buy Across State Lines" chestnut again"

UPDATE 12/11/25: Kentucky GOP Senator Rand Paul went on FOX Business yesterday to once again push "Buying Across State Lines" (BASL) as a solution to health insurance woes yet again, so it seems like a good time to re-up this post.

(sigh) Here we go again...via CMS:

CMS seeks recommendations that allow Americans to purchase health insurance across state lines

Administration continues efforts to increase consumer choice, promote competition and drive down prices in the health insurance market

OK, I know I said I wasn't gonna do a deep dive into any more last-ditch GOP bills ahead of tomorrow's big Senate vote, but this one looks intriguing...but not just for the reasons you might think.

Earlier today, GOP Rep. Jen Kiggans & Democratic Rep. Josh Gottheimer introduced Yet Another short-term enhanced ACA tax credit extension bill...but this one has some very interesting twists.

Via Politico:

The mounting support for the legislation, offered by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.), comes as House GOP moderates expressed frustration in a conference meeting Wednesday morning over their leadership’s proposals to address spiking health insurance premiums — without dealing with the expiring tax credits.

 

via Meredith Lee hill in Politico:

House GOP erupts over health care as leaders hunt for a plan

House Republican leaders presented no firm plan Tuesday for advancing health care legislation as anxiety rises in the GOP ranks over the impending expiration of key Obamacare subsidies at the end of the year.

Instead, Speaker Mike Johnson presented attendees of a closed-door conference meeting with list of 10 possible policies that could get votes in the coming weeks or months, according to five Republicans in the room.

Some were more specific, such as an expansion of health savings accounts and an overhaul of pharmaceutical benefit manager oversight. Others were vague, including one bullet point that simply said, “Innovation.” The list did not include an extension of the expiring tax credits.

via Covered California's Open Enrollment Dashboard, as of December 6th:

  • New enrollments: 62,247
  • Active renewals: 389,329
  • Passive Autorenewals: 1,363,264
  • Total: 1,814,840

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 is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).

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 451,576 combined. This also means that only 22% of current enrollees had actively re-enrolled as of 12/06.

As of the same point last year (actually 1 day more; the data from last year is as of 12/07), Covered CA was reporting:

via Connect for Health Colorado:

Denver, Colo. – The Dec. 15 deadline to enroll in health insurance for Jan. 1 is fast approaching, and Connect for Health Colorado, the state’s official health insurance marketplace, is encouraging people to shop and start their applications today to avoid a lapse in coverage. 

“Dec. 15 is an important deadline; it’s the final day for Coloradans to enroll in health coverage that starts Jan. 1, and our team is ready to help customers stay covered,” said Kevin Patterson, chief executive officer of Connect for Health Colorado. “Staying covered is one of the most important things people can do for their physical and financial well-being. Gaps in coverage can leave Coloradans vulnerable to unexpected medical costs – but we’re here to help. We want to be sure people have the information and assistance they need to choose a plan that works for them.”

Washington HealthPlan Finder

via the Washington HealthBenefit Exchange:

Amid tax credit uncertainty, many Washingtonians are still finding their health insurance for 2026 through Washington Healthplanfinder

OLYMPIA, Wash. – During the first month of open enrollment for 2026, more than 268,000 Washingtonians used Washington Healthplanfinder to shop, compare and sign up for health and dental insurance. Even though enhanced premium tax credits for next year may not be extended through Congress, many customers can still find plans with state and federal savings.

Open enrollment is currently underway for 2026, people who sign up by Dec. 15 will have coverage that starts on Jan. 1.  Everyone who signs up between Dec. 16 and Jan. 15 will have plans that begin on Feb. 1. At wahealthplanfinder.org, Washingtonians can shop for themselves or find help from a trusted resource in their community. Premium savings may be available to help make monthly costs more affordable.

via Access Health CT:

HARTFORD, Conn. (Dec. 8, 2025) — Access Health CT (AHCT), Connecticut’s official health insurance marketplace, today announced the deadline to enroll in health and dental coverage starting Jan. 1, 2026 is Dec. 15, 2025. Customers who enroll Dec. 16, 2025 through Jan. 15, 2026 will have coverage beginning Feb. 1, 2026.

The Open Enrollment Period for Connecticut residents to shop, compare and enroll in health insurance or renew their coverage began Nov. 1, 2025 and runs through Jan. 15, 2026. Customers may enroll in health and dental coverage. 

Hot on the heels of Republican Senators Bill Cassidy of Louisiana & Mike Crapo of Idaho presenting their so-called "Health Care Freedom for Patients Act" which would do almost nothing to actually help ACA enrollees while causing more harm to transgender individuals (of course) and undocumented immigrants (of course), at least two more "The clock is ticking, we have to come up with SOMETHING!" bills have been rolled out today by Congressional Republicans.

First up is this one from former centrist Democrat-turned-MAGA-Republican Congressman Jeff Van Drew of New Jersey (h/t Andrew Sprung for bringing it to my attention):

Washington, DC -Today, Congressman Van Drew joined a bipartisan coalition of House members calling for a short-term extension of the Affordable Care Act's (ACA) tax credits with targeted modifications of the system. The group also sent a letter to House and Senate leadership asking for a meeting to discuss a clear path forward for health insurance.

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