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:
The first official press release from the Centers for Medicare & Medicaid Services (CMS) under the Trump 2.0 Administration is out, and not only is it pretty innocuously worded...it's actually complimentary of the Inflation Reduction Act, which is noteworthy given that the IRA was passed & signed into law exclusively by Democrats & President Biden:
CMS Statement on Lowering the Cost of Prescription Drugs
Lowering the cost of prescription drugs for Americans is a top priority of President Trump and his Administration. In accordance with the statutory requirements of the Inflation Reduction Act, the Centers for Medicare and Medicaid Services (CMS) released the list of 15 drugs selected for the second cycle of the Medicare Drug Price Negotiation Program on January 17, 2025.
Early Monday evening I received a copy of a memo that will impact thousands of institutions supported by funding from the federal government.
A copy of the memo from the Office of Management and Budget (OMB) was provided to The Handbasket at approximately 5pm ET by a source whose anonymity is being protected for fear of professional retribution. The memo was sent to the heads of executive departments and agencies with the subject, “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” I shared the news on Bluesky at 6:04pm ET, and my reporting was confirmed by the Washington Post a few hours later.
It is a truly unhinged document that sounds like it was written by the world’s most petty 4Chan poster—but then again, that’s who’s currently running our federal government. Here’s the first paragraph to get a feel for it (emphasis mine):
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:
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:
Below I'm posting a similar breakout of total ACA Medicaid Expansion enrollment from January 2014 - June 2024, via the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports (warning: That link could be broken or blank by the time you read this under the Trump Administration).
Unfortunately, the MBES reports currently only run through June of last year, so the last half of the year is missing.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.
Click the image for a higher-resolution version. I'm not bothering to include the state labels since some would be too difficult to make out, but it starts with Alaska at the bottom and works its way up to West Virginia at the top (remember, neither Alabama nor Wisconsin or Wyoming have expanded Medicaid under the ACA). It also includes Guam, Puerto Rico and the U.S. Virgin Islands.
There's still likely up to perhaps ~30,000 or so Qualified Health Plan (QHP) enrollments to be added to the 2025 Open Enrollment Period (OEP) tally from the states which haven't reported their final, data (in fact, CA, DC, NJ, NY & RI haven't ended theirs yet), but I decided to throw this together today for the hell of it.
The table below charts the the first twelve years of ACA Open Enrollment Periods, broken out by state. I've also included Basic Health Plan (BHP) enrollment in Minnesota, New York and (new last summer) Oregon, the only states where BHP programs have been implemented to date.
No further analysis or comment here; I just think this is a pretty cool graphic which demonstrates visually how the ACA has grown over time to become firmly embedded into the U.S. healthcare landscape. Source: CMS Marketplace Open Enrollment Period Public Use Files for 2014 - 2024; Semi-final OEP Snapshot Report for 2025 (along with some nominal updates from a few of the state-based exchanges):
Connect for Health Colorado Sets a New Record: 282,483 People Enrolled in Health Insurance for Plan Year 2025
Denver, Colo. – Connect for Health Colorado, the state’s official health insurance marketplace, announced today a record 282,483 Coloradans have enrolled in health insurance for plan year 2025, with 80% receiving financial assistance to reduce the cost of their premiums.
The total number of people who enrolled in health insurance plans for 2025 is 19% higher than the number who enrolled in 2024.
Over 110,000 Nevadans got enrolled, marking the largest enrollment in the history of Nevada’s marketplace
CARSON CITY, Nev. – Nevada Health Link has achieved a historic milestone this year with its record-setting Open Enrollment Period for Plan Year 2025. With over 110,000 Nevadans enrolling in affordable and comprehensive health and dental coverage through the state-based marketplace, this achievement underscores the critical importance of providing accessible and affordable health insurance options to Nevadans across the state.
“Reaching the highest enrollment numbers in Nevada Health Link’s history is a milestone we’re incredibly proud of,” said Russell Cook, Executive Director of Nevada Health Link. “Health insurance is more than just a safety net in case of a medical emergency – it's peace of mind, financial security, and, ultimately, a pathway to better health outcomes for individuals and families across our state. This record-setting enrollment underscores the importance of our mission to prioritize the well-being of Nevada’s communities.”
Vulnerable House Republicans warn leaders against cutting Obamacare
The group of centrists also said the party needed to be careful about deep cuts to social safety net programs.
House Republicans in competitive districts warned GOP leaders Thursday: We could lose our seats if you gut Obamacare to pay for a massive border, energy and tax bill.
A group of about a dozen centrist Republicans...worry GOP efforts to pare back the Affordable Care Act could pour fuel on the fire.
...Instead, they argued, Republicans needed to embrace the GOP’s role as the working class party. Leaders would counter that message by slashing programs working Americans rely on, they said. GOP lawmakers in the room included Rep. Brian Fitzpatrick (Pa.), Young Kim (Calif.), David Valadao (Calif.), Andrew Garbarino (N.Y.), Tom Barrett (Mich.) and Don Bacon (Neb.).
