ARP

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

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

• The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;

• 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;

• 100,000 or more DACA recipients are finally eligible to enroll in ACA exchange plans & receive financial assistance!*

*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.

Update 12/09/24: As expected, a federal court has shot down the eligibility of DACA recipients to enroll in ACA exchange coverage in the 19 states involved in the lawsuit. In theory the roughly 2/3 of DACA recipients living in the other 31 states +DC should still be eligible.

Update 12/19/24: OK, never mind: Another federal court has put a stay on the DACA enrollment injunction, so for the moment DACA recipients can enroll in every state.

Update 12/23/24: Rhode Island has extended their 2025 Open Enrollment period all the way out through the end of February due to the nasty security breach of RIBridges, their social services IT system. Anyone who enrolls thru 2/28/25 will have their coverage made retroactive to January 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:

Back in June, I ran a state-by-state analysis which provided estimates of just how much various households would see their net individual market premiums jump starting in 2026 if the upgraded financial subsidies originally included in the American Rescue Plan Act (and later extended by the Inflation Reduction Act) are allowed to expire at the end of 2025, as is currently scheduled to happen without legislative action.

This week, the Robert Wood Johnson Foundation (RWJF)* has published their own take on the financial impact on enrollees if the IRA subsidies are allowed to expire. In this case, however, they're approaching it from a slightly different angle: They're focusing specifically on the approximately 1.7 million ACA exchange enrollees who earn more than 400% of the Federal Poverty Level (FPL).

*Disclosure: RWJF is a sponsor of this website.

The official 2024 ACA Open Enrollment Period (OEP) ended last night in most states, but millions of Americans are still eligible to #GetCovered!

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

• The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through 2025 via the Inflation Reduction Act;

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

• Millions more Americans who weren't previously eligible for ACA subsidies (even with the expanded ARP/IRA enhancements) are now eligible via the Biden Administration's closure of the so-called "Family Glitch."

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 2024:

The 2024 ACA Open Enrollment Period (OEP) is STILL ongoing in 49 states +DC.

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

• The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through 2025 via the Inflation Reduction Act;

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

• Millions more Americans who weren't previously eligible for ACA subsidies (even with the expanded ARP/IRA enhancements) are now eligible via the Biden Administration's closure of the so-called "Family Glitch."

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 2024:

Over at Inside Health Policy, Amy Lotven confirms that House Democrats haven't forgotten about the pending expiration of the upgraded federal subsidies provided by the American Rescue Plan and extended via the Inflation Reduction Act last summer:

While the Census found the percentage of Americans without insurance fell, even as a supplemental poverty measure increased following the end of pandemic-era assistance, ranking House Ways & Means Committee Democrat Richard Neal (MA) is highlighting the need to extend the enhanced Affordable Care Act credits that are set to expire at the end of 2025.

The 2023 ACA Open Enrollment Period is still ongoing in 6 states, and many people can still enroll in other states as well!

The 2023 OEP is the best ever for the ACA for several reasons:

• First, the expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing for at least another 3 years via the Inflation Reduction Act;

• Second, because several states are either expanding or retooling their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;

• And third, because millions more Americans who weren't previously eligible for ACA subsidies (even with the expanded ARP/IRA enhancements) are now eligible via the Biden Administration's closure of the so-called "Family Glitch."

There's also expanded carrier & plan offerings in many states/counties, and as always, 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 thirteen important things to know when you #GetCovered for 2023:

Back in 2019, long before the American Rescue Plan passed, I embarked on an ambitious project. I wanted to see what the real-world effects would be of passing a piece of legislation which would eliminate the Affordable Care Act's so-called "Subsidy Cliff" while also strengthening the subsidy formula for those who qualified. Call it "ACA 2.0" for short, if you will (that's what I do, anyway).

This legislation has been around in near-identical form under one official title or another for years, usually bundled within a larger healthcare package. In 2018 it was called the "Undo Sabotage & Expand Affordability of Health Insurance Act of 2018" (or "USEAHIA" which is about as awkward a title as I can imagine.

In 2019 it was rebranded as the "Protecting Pre-Existing Conditions and Making Healthcare More Affordable Act" or "PPECMHMAA," which somehow managed to be even more awkward.

I haven't written about the ACA's Medical Loss Ratio (MLR) rule in awhile. I was pretty obsessed with it a few years ago, and I still check in on it from time to time, but otherwise I've mostly moved on to other things.

HOWEVER, the MLR rule is still pretty important...and while the dollar amounts I'm about to discuss aren't much more than a rounding error in terms of federal budget numbers, it's possible that the could play a small role in helping get a much larger project moving forward.

Before I begin, here's a short refresher on how the MLR rule works:

Last week the Centers for Medicare & Medicaid posted a new press release about a new report from the HHS's Assistant Secretary for Planning & Evaluation (ASPE) which has updated ACA-specific enrollment data current as of October 2021 - March 2022:

New Reports Show Record 35 Million People Enrolled in Coverage Related to the Affordable Care Act, with Historic 21 Million People Enrolled in Medicaid Expansion Coverage

Last June, the U.S. Health & Human Services Dept. confirmed my estimate that total enrollment in healthcare policies either specifically created by (or expanded to more people by) the Affordable Care Act had broken 31 million Americans:

Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs.

HHS's breakout was fairly close to mine, though they had enrollment a bit higher in some categories and a bit lower in others:

And there it is: