Charles Gaba's blog

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding April 2025 to the data archive.

Whether the data posted since January 20, 2025 is accurate or not, I can't say for certain, but at least they're updating it...and so far, at least, I don't see anything in their monthly reports which is setting off any obvious red flags.

In any event, according to the latest report, as of April 2025:

Originally posted 12/19/24

Colorado has around ~282,000 residents enrolled in ACA exchange plans, 80% of whom are currently subsidized. I estimate they also have another ~39,000 unsubsidized off-exchange enrollees.

Combined, that's 321,000 people, although assuming the national average 6.6% net enrollment attrition rate applies, current enrollment would be back down to more like 322,000 statewide.

via the Washington Health Benefit Exchange:

Public comment at Washington Health Benefit Exchange Board  includes 10 testimonials, plus additional stories 

OLYMPIA, Wash. – Washingtonians shared stories of how access to more affordable health insurance has affected lives and communities all across the state, with Washington Health Benefit Exchange (Exchange) Board last week. The testimonials were particularly impactful in light of a myriad of recent federal changes to state-based marketplaces such as the Exchange, and the impending potential expiration of enhanced premium tax credits (ePTC) before Congress.  

via Covered California:

La versión en español de este Comunicado puede ser descargada en este enlace.

SACRAMENTO, Calif. — Due to recent rule changes made by the federal government, Covered California enrollees who are part of the Deferred Action for Childhood Arrivals (DACA) program will have their Affordable Care Act health insurance terminated on Aug. 31, 2025. The federal rule will affect more than 2,300 DACA recipients in California.

via Peter Sullivan & Victoria Knight of Axios:

More congressional Republicans are saying they could support a limited extension of enhanced Affordable Care Act subsidies — but only as part of a wider deal and with possible new limits to the assistance.

Why it matters: Democrats are pushing for a clean extension, but the more realistic path, if there's one at all, is a short-term extension that includes conservative health policies.

What they're saying: "How many clean extensions have you seen of late?" said Sen. Thom Tillis, who began pushing for a subsidy extension in the spring. He added that he didn't know what the contours of a deal could look like.

...Changes that could make an extension more palatable for Republicans include limiting the subsidies for higher-income enrollees or requiring that all enrollees pay at least some cost-sharing or premiums.

Originally posted 7/17/25

Now that I've finally completed overhauling & updating my House District Healthcare Enrollment Pie Chart project with the latest data, I wanted to address a rather frustrating elephant in the room.

For most of the healthcare programs involved, the enrollment data is now reasonably up to date:

• ACA Qualified Health Plan (QHP) enrollment is as of February 2025 via official Centers for Medicare & Medicaid Services (CMS) public use files.

• ACA Basic Health Plan (BHP) enrollment is as of April 2025 (NY), May 2025 (OR) or July 2025 (MN) via each state's health department monthly reports.

(with apologies to “Weird Al” Yankovic)

Last winter, I initiated an ambitious project in which I generated graphics to illustrate just how much net ACA premiums are likely to increase starting on January 1st, 2026 (slightly over 5 months from today) assuming the enhanced premium subsidies provided by the Inflation Reduction Act over the past several years are allowed to expire.

This project took several months to complete, as I had to generate both tables and bar graphs for all 50 states (+DC), using 4 different households at multiple income brackets for each. All told, that's over 1,600 different examples.

I made sure to include various caveats for these projections. For instance, each of these examples assumes...

The Trump Regime has published an update to the official Medicaid/CHIP enrollment data:

April 2025 Key Findings - Medicaid and CHIP Enrollment

• In April 2025, 78.4 million individuals were enrolled in Medicaid and CHIP.
• 71.1 million individuals were enrolled in Medicaid, and 7.3 million individuals were enrolled in CHIP.
• 41.1 million adults were enrolled in Medicaid, and there were 37.3 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

I joined my friend Laura Packard of CareTalk earlier today to discuss the upcoming IRA subsidy expiration iceberg which the ACA Titanic is about to hit just 5 months from today.

(if you tune in while the show is still airing live you'll have to scroll back to the beginning to see my segment)

Me, on April 22nd:

So, all of that was last summer. Skip ahead ten months and voila, the U.S. Supreme Court did indeed hear arguments in the case yesterday...and while the headline from the AP makes it sound positive, there's a potentially very dark lining as well:

 The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.

Conservative justices Brett Kavanaugh and Amy Coney Barrett, along with the court’s three liberals, appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.