Almost exactly a year ago I began my 2025 ACA Open Enrollment Period guide with the following words:

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!

What a difference a year can make.

SCROLL DOWN FOR UPDATES

Every year, I spend months painstakingly tracking every insurance carrier rate filing (nearly 400 for 2025!) for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease.

Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.

I really only need three pieces of information for each carrier:

USE THE DROPDOWN MENU ABOVE TO PICK A STATE.

9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:

Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:

I should also note that I've started cross-posting key entries at Substack as well.

BeWell NM, New Mexico's ACA exchange, is the only state marketplace with ongoing daily enrollment data reports:

New Mexico Open Enrollment 2026 - Enrollment Summary

Last Refreshed On: December 2, 2025

Officially, they're reporting 75,926 Qualified Health Plan (QHP) enrollments already, which is actually 8% higher than the 70,373 which they ended with during the 2025 Open Enrollment Period (OEP) last January.

HOWEVER...and this is a major caveat...that 75,926 includes all current enrollees being auto-renewed for 2026, which doesn't really count for my purposes. Most state exchanges used to hold off on lumping in the auto-renewals until after the initial December deadline, only reporting current enrollees who actively re-enroll along with new enrollees.

When I look at it that way, I get:

 

Earlier this afternoon I joined cancer survivor and healthcare reform advocate Laura Packard on her CareTalk podcast to discuss the upcoming expiration of the enhanced ACA tax credits and the Trump Regime's confusing, will-they-or-won't-they non-proposal to maybe, possibly extend them...with a bunch of major caveats attached. Tune in!

*(OK, not really, but good lord this should still make a lot of his colleagues sweat)

For nearly a year now I've been shouting from the rooftops about the eye-popping net premium hikes which millions of ACA enrollees are going to see starting one month from today, assuming the enhanced Advanced Premium Tax Credits (eAPTC) which have been in place for the past five years are allowed to expire on New Year's Eve.

I've put together 51 bar graphs showing examples of what these net premium increases will look like for various households at different income levels in every state. Since there's so many variables from state to state including different Rating Areas, different levels of carrier participation, different provider networks and different benchmark Silver plans from county to county (and even from zip code to zip code), I decided to use the capital city of each state as my rule of thumb.

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

August 2025 Key Findings

Medicaid and CHIP Enrollment

  • In August 2025, 77.3 million individuals were enrolled in Medicaid and CHIP.
  • 70.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 40.4 million adults were enrolled in Medicaid, and there were 36.9 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

The Centers for Medicare & Medicaid Services just published updated enrollment data for Medicare, adding July and August 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 August 2025:

  • Total Medicare beneficiaries are up to 69.3 million (up ~86K month over month)
  • Traditional/FFM Medicare beneficiaries are at 33.79 million (down ~31K m/m)
  • Medicare Advantage beneficiaries reached 35.49 million (up ~55K m/m)
  • 11.73 million Medicare enrollees (around 16.9% of the total) were "Dual Eligibles"...that is, enrolled in both Medicare and Medicaid.

The only number which seems odd is the 375K drop in Dual Eligibles...I'm not sure what to make of that.

Past Due Podcast

I recently joined Ana Marie Cox & Open Mike Eagle on the Past Due Podcast to discuss the how to deal with this year's crazy ACA Open Enrollment Period. Tune in!

 

(with apologies to "Weird Al" Yankovic)

Yesterday, Politico reported that the Trump 2/3 White House was planning on rolling out his own counterproposal to Democrats demand that the enhanced ACA tax credits (which are still scheduled to expire just 36 days from now) be extended (preferably permanently, but at the bare minimum by at least a few years).

According to the Politico story, the Trump proposal supposedly included the following provisions:

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