You'll have to forgive me my poor metaphor below, but it's the best I can think of at the moment. I've been awake for 29 hours straight now, as I woke up at 5am yesterday for a 15-hour shift as a poll worker in Pontiac, Michigan, and, like many of you I'm sure, I was unable to sleep at all last night. I just got off a devastating phone call with my son who's a freshman in college who doesn't understand why what just happened...happened.

There's going to be a mountain of digital & physical ink spilled and a cacophony of talking heads on the Sunday morning shows yapping about What Went Wrong, yadda yadda yadda. Most of it will be bullshit. Some of it will be accurate.

Since writing about healthcare is my thing, and writing about the ACA specifically is very much in my wheelhouse, I'm going to put my take on this into healthcare risk pool terms. Besides, assuming the GOP also keeps control of the House, the ACA is likely gone (and even if they don't, it's about to be radically gutted via regulatory actions anyway), so I might as well.

The 2025 ACA Open Enrollment Period (OEP) officially begins on November 1st.

This is the best OEP ever for the ACA for several reasons:

  • A dozen states are either launching, continuing or expanding their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;

*Note: There's still some uncertainty about this, as 19 Republican Attorneys General have filed a lawsuit to block this, and oral arguments were heard just a week or so ago, so it's conceivable that an injunction will be placed before November 1st.

And remember, millions of people will be eligible for zero premium comprehensive major medical policies.

If you've never enrolled in an ACA healthcare policy before, or if you looked into it a few years back but weren't impressed, please give it another shot now. Thanks to these major improvements it's a whole different ballgame.

Here's some important things to know when you #GetCovered for 2025:

OK, I'm about a week behind on this but I've been a wee bit preoccupied of late...

Via the Centers for Medicare & Medicaid Services (CMS):

On November 8, 2024, the Centers for Medicare & Medicaid Services (CMS) released the 2025 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2025 Medicare Part D income-related monthly adjustment amounts. 

Medicare Part B Premium and Deductible

Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.

via DC Health Link:

DC Residents Can Get Covered at DCHealthLink.com from November 1, 2024 – January 31, 2025 

(Washington, DC) – Mayor Muriel Bowser announced that the 2025 Open Enrollment period will start tomorrow, Friday, November 1, and is encouraging DC residents to sign up for high-quality, affordable health insurance at DCHealthLink.com, the District’s online state-based health insurance marketplace. Open enrollment for individuals and families begins on November 1, 2024 and continues through January 31, 2025.

“Part of making sure that everyone in our community is getting the right care at the right time means getting more residents insured,” said Mayor Bowser. “We are making high-quality health care more affordable for more residents and using insurance to address disparities in health outcomes. We want Washingtonians to check out their options and get covered.

via Pennie:

To start coverage on January 1, 2025, Pennsylvanians must enroll by December 15, 2024

Harrisburg, PA – With the Shapiro Administration committed to cutting costs and delivering results for Pennsylvanians, the Pennsylvania Insurance Department (PID), Department of Human Services (DHS), and Pennie joined together today to remind Pennsylvanians that Pennie’s Open Enrollment period is underway, offering affordable health insurance options for 2025.

“This Open Enrollment period is the best time to explore available options and shop around to find a plan — even if you already have insurance. Quality, comprehensive health care coverage has never been more affordable, or more within reach for Pennsylvanians,” said Pennsylvania Insurance Commissioner Michael Humphreys. ”PID’s focus on increasing Marketplace competition has delivered more choices and greater affordability for consumers across the Commonwealth.”

via Politico:

Trump expected to select Robert F. Kennedy Jr. to lead HHS

President-elect Donald Trump is expected to nominate former presidential candidate and anti-vaccine activist Robert F. Kennedy Jr. to lead the Department of Health and Human Services, according to a person with direct knowledge of the selection.

The expected pick, which will roil many public health experts, comes after Trump promised to let Kennedy “go wild” with health and food policy in his administration after Kennedy dropped his own presidential bid to endorse the now-president-elect. It’s also a sign of the opening Trump sees after he scored a decisive electoral victory and Republicans won a comfortable majority in the Senate.

Trump could still select someone else for the post. The Trump transition couldn’t immediately be reached for comment.

“He’s going to help make America healthy again. … He wants to do some things, and we’re going to let him get to it,” Trump said in his victory speech. “Go have a good time, Bobby.”

Eight years ago I posted the following:

ACA Signing Off.

I made a commitment to keep this site up and running through next spring, and I intend on keeping this commitment. Beyond that, I have no idea what my plans for the site are.

After yesterday's atrocity, however...I'm honestly dreading the thought of what most of my charts, graphs, spreadsheets and blog entries are going to look like.

You see those impressive-looking odometer-style numbers at the top of the home page? Yeah, forget about those. They're meaningless now.

A lot of people will still sign up, but I'm guessing many who were planning on doing so once they were certain the ACA would still be around next year are now going to take a pass. And that's simply the beginning.

Beyond that...it's 4:30am. I'm exhausted, my stomach hurts and my hands are shaking.

God help us all.

I've spent the past week trying to decide how to approach the elephant in the room this time around.

via Access Health CT:

Enrollment Specialists available at events to help consumers in English and Spanish

HARTFORD, Conn. (Nov. 1, 2024) — Access Health CT (AHCT) today announced it will hold 10 enrollment fairs in November to help Connecticut residents shop, compare, and enroll in health or dental coverage. They can also renew their coverage. Enrollment fairs are one-day events for customers to get free, in-person help from experts. The fairs will take place in Bridgeport, Bristol, Fairfield, Hartford, Middletown, New Haven, Norwalk, Torrington, Waterbury and Willimantic.

Open Enrollment begins today. When you enroll affects when your coverage starts. If customers enroll on or before Dec. 15, 2024, coverage will start Jan. 1, 2025. If they enroll between Dec. 16, 2024, and Jan. 15, 2025, coverage will start Feb. 1, 2025.

via Connect for Health Colorado:

Our Work Continues Post-Election

I want to acknowledge the questions about the future of health policy since Tuesday’s election.

We’ve successfully navigated periods of uncertainty like this several times in the past, including eight years ago, and we didn’t do it alone. You, our customers, stakeholders, and partners, make it possible to move forward together.

There are several things that we know.

The Affordable Care Act is still the law of the land.

Senate Bill 11-200, the state law that created Connect for Health Colorado, is still the law of the state. There are several other important state laws that ensure quality, affordable, and comprehensive health coverage for Coloradans.

There are significant savings available to customers who enroll through the Marketplace for Plan Year 2025.

Sorry about the headline, but it's kind of difficult to focus on stuff which seems pretty mundane at the moment.

Still, it is part of my job to analyze the annual weighted average premium rate changes for ACA individual & small group policies to the best of my ability, so I'm doing that.

The final/approved rates for 2025 mostly come from the federal rate review database, although in some states they come directly from their insurance department website or the SERFF database.

Oddly, the federal rate review database still only has partial data for Oklahoma and Tennessee, and none at all for Wyoming, even though we're nearly a week open enrollment, so I can't plug those in yet. Huh.

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