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.

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:

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

Under the Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from January 1, 2025 – March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation. Over 853,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and substance use disorder. Since April 1, 2023, people with Medicare have seen savings on over 120 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.

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) just now:

The Centers for Medicare & Medicaid Services (CMS) is committed to a robust Marketplace Open Enrollment process for consumers so they can easily purchase high-quality, affordable health care coverage. CMS reports that a record 16.6 million consumers signed up for plan year 2025 and will receive up to a full year of coverage beginning January 1. Of those consumers, 2 million are new to the Marketplace this year. This represents selections in the 31 states that use HealthCare.gov. Plan selection continues in most State-based Marketplaces, as well. The next national snapshot will be available in early January.

The footnote at the bottom confirms: "These metrics reflect available Federally-facilitated Marketplaces (FFMs) data through December 18, 2024."

via MNsure:

Over 150k Minnesotans have signed up for health insurance since November 1

ST. PAUL, Minn.—Following last year’s incredible enrollment success, MNsure is pleased to report yet another new record for health insurance sign-ups in Minnesota.

Between November 1 and the first deadline (December 18), 151,098 Minnesotans used MNsure.org to sign up for qualified health plans. This represents a 14% increase in private health plan sign-ups compared to the same time last year.

This is excellent news, however, as happens every year with MNsure, it comes with a big caveat.

As I noted a year ago:

This is great, but the 11% higher y/y figure is a bit confusing to me, actually.

Over at my 2025 Open Enrollment Period "15 Important Things" guide, I noted the following:

Idaho actually already launched their 2025 Open Enrollment Period on October 15th, and it only runs through December 16th.*

...*Idaho has continued to doing this even though Nov. 1st has almost always been the official start date and the Biden Admin extended the end date out to Jan. 15th several years ago. The Centers for Medicare & Medicaid Services (CMS) issued new rules last year which I had thought were supposed to crack down on this & bring Idaho in line with other states, but apparently the Gem State was grandfathered in.

That last link goes to this entry from October 11th:

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:

Nevada Health Link hasn't published a formal press release about this yet (I'm assuming they're waiting until they actually break 100K to do so, which would be perfect timing since the deadline to enroll for January 1st coverage is New Year's Eve), but I just found this in their December Executive Director's Report from 2 days ago:

OPEN ENROLLMENT 2025

Following the close of week seven, the Plan Year 2025 OEP is the Exchange’s highest performing to date. The annual passive renewals (or Auto-renewals) job was completed in mid-October with a greater than 99.9% renewal success rate.

Holy crap. That's astonishing.

When OEP began on November 1, 91,555 individuals were enrolled in 2025 health coverage, and 16,820 individuals were enrolled in dental coverage, our highest starting numbers ever.

(I'm assuming that's a typo & should be 2024 health coverage, since obviously you can't have anyone enrolled in 2025 coverage prior to OEP launching).

Here's the key point, though:

The Centers for Medicare & Medicaid Services (CMS) has published two 2025 ACA Open Enrollment Period "snapshot reports," both of which had above-the-fold numbers which make it look as though enrollment numbers are lagging significantly behind last year's record-breaking totals:

The Centers for Medicare & Medicaid Services (CMS) is committed to creating a robust Marketplace Open Enrollment process for consumers so they can effortlessly purchase high-quality, affordable health care coverage. CMS reports that nearly 988,000 consumers who do not currently have health care coverage through the individual market Marketplace have signed up for plan year 2025 coverage.

OMG! Last year over 1.6 milllion new enrollees had signed up as of the first snapshot report...over 66% more!

via the NJ Dept. of Banking & Insurance:

NJDOBI Announces Record Enrollment to Date for 2025 Health Insurance Through Get Covered New Jersey

Residents Must Enroll by Dec. 31 for Coverage Starting Jan. 1; Open Enrollment Ends Jan. 31

TRENTON — Nearly 450,000 New Jersey residents have signed up for a 2025 health insurance plan through Get Covered New Jersey, the state’s Official Health Insurance Marketplace, in the first five weeks of the state’s Open Enrollment Period – a dramatic increase from 330,901 who had selected plans by this time last year, New Jersey Department of Banking and Insurance (DOBI) Commissioner Justin Zimmerman announced today.

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