Charles Gaba's blog

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.

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:

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

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

September 2024 Key Findings

Medicaid and CHIP Enrollment

  • In September 2024, 79.4 million individuals were enrolled in Medicaid and CHIP.
    • 72.2 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
    • 41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Every month for years now, the Centers for Medicare & Medicare Services (CMS) has published a monthly press release with a breakout of total Medicare, Medicaid & CHIP enrollment; the most recent one was posted in late February, and ran through November 2022.

Since December 2022, however, they haven't sent out the normal press release; instead, they included a brief note leading to a Medicaid/CHIP data slideshow , along with another note leading to their new Medicare Monthly Enrollment database.

In any event, according to the spreadsheet I exported, as of September 2024:

ORIGINAL STORY & PRIOR UPDATES HERE.

(sigh) Goddammit. This isn't terribly surprising but it's still pretty disappointing.

As laid out in my prior (repeatedly updated) story about this ongoing saga, the eligibility of up to 100,000 or so uninsured DACA recipients to enroll in healthcare coverage via the ACA marketplaces has been bouncing back & forth for some time now. President Biden originally made a rule change to make them eligible to enroll back in May 2024. Unfortunately, earlier this fall a coalition of 19 Republican state Attorneys General filed a lawsuit to block the Biden Administration from enrolling DACA recipients, and the courts have ping-ponged their status a few times ever since.

Things were looking good a week or so ago when the 8th Circuit Court issued a stay on the injunction...but I just got the most recent ruling from the 8th Circuit Court, and it's bad news:

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

This morning, the Twitter account NewsWire_US, which claims to be a "U.S. and world news aggregator," posted an amazing-looking graph which purports to break out "Obamacare applications by state for 2025" by states which voted for Donald Trump vs. those which voted for Kamala Harris last month.

Here's the graph, which includes no further context (including any data sources...NewsWire claims it came from Reuters but I can't find the original link to a story by them with this graph) beyond making it look like a whopping 82% of ACA enrollees live in Trump states:

Update: Here's the original Reuters article, which was actually published on Dec. 11th, which at least explains why it only includes data through Nov. 16th/9th, anyway.

Update: Newsweek has run with the ball on this story without actually looking at the data properly as well.

It was in early 2021 that Congressional Democrats passed & President Biden signed the American Rescue Plan Act (ARPA), which among other things dramatically expanded & enhanced the original premium subsidy formula of the Affordable Care Act, finally bringing the financial aid sliding income scale up to the level it should have been in the first place over a decade earlier.

In addition to beefing up the subsidies along the entire 100 - 400% Federal Poverty Level (FPL) income scale, the ARPA also eliminated the much-maligned "Subsidy Cliff" at 400% FPL, wherein a household earning even $1 more than that had all premium subsidies cut off immediately, requiring middle-class families to pay full price for individual market health insurance policies.

Here's what the original ACA premium subsidy formula looked like compared to the current, enhanced subsidy formula:

Last week I reposted a press release & video from the Rhode Island Dept. of Administration explaining the details of a major security breach of the state's social services system.

Today it looks like the issue was a lot worse than I thought. via WPRI:

On Monday, Gov. Dan McKee said his team has identified 650,000 people whose personal information was stolen in the recent cyberattack on the state’s IT system for social services.

Yikes. FWIW, Rhode Island only has around 1.1 million people, so this basically means that 60% of the entire state population has had their personal info compromised. 

...Earlier this month, the cyberattack shut down the state’s IT system known as RIBridges, which serves as an eligibility database for a host of social services, such as SNAP and Medicaid, along with subsidized health insurance through HealthSourceRI.

Pages

Advertisement