Over at the JAMA Network, KFF Executive VP for health policy Larry Levitt has a piece which lays out the most likely actions (or in one case, lack of action) that the incoming Trump Administration & Republican-controlled Congress will take now that they have a second shot at repealing the Affordable Care Act:

With many tax cuts from the 2017 Tax Cuts and Jobs Act expiring at the end of 2025, a high-profile Congressional debate over extending those tax reductions and enacting new ones is likely. There will be pressure from some in Congress for spending cuts to help pay for those tax cuts. Trump has said that Social Security and Medicare cuts are off the table, and defense reductions are unlikely as well. That means almost half of federal spending would be protected from cuts, leaving Medicaid, which is the next largest source of federal spending, and the ACA as prime targets for spending cuts. The math is inescapable.

Not that this should surprise anyone, but it's good to have the Congressional Budget Office (CBO) formally chime in:

Re: The Effects of Not Extending the Expanded Premium Tax Credits for the Number of Uninsured People and the Growth in Premiums

Dear Chairman Wyden, Ranking Member Neal, Senator Shaheen, and Congresswoman Underwood:

You have asked the Congressional Budget Office to discuss the effects on health insurance coverage and premiums that will result from not extending—either for one year or permanently—the expanded premium tax credit structure provided in the American Rescue Plan Act of 2021 (ARPA, Public Law 117-2).

ARPA reduced the maximum amount eligible enrollees must contribute toward premiums for health insurance purchased through the marketplaces established by the Affordable Care Act, and it extended eligibility to people whose income is above 400 percent of the federal poverty level (FPL). Those provisions were extended through calendar year 2025 in the 2022 reconciliation act (P.L. 117-169).

via the Maine Insurance Dept:

Maine Superintendent of Insurance Bob Carey encourages Maine consumers to be cautious when shopping for health plans during the annual Affordable Care Act (ACA) open enrollment period.  Open enrollment for plan year 2025 is open now. For coverage to begin on January 1, 2025, Maine people must enroll by December 15, 2024. The final deadline to enroll is January 15, 2025 for coverage to begin on February 1, 2025.

The Maine Bureau of Insurance wants consumers to be aware that many legitimate-looking health plans they may see when doing an internet search may not offer comprehensive coverage and may not be authorized to be sold in Maine.

Consumers are urged to shop for plans at CoverME.gov, Maine’s health insurance marketplace, which offers health plans that have been reviewed and approved by the Bureau of Insurance and is the only place Maine residents can get financial savings to lower monthly premiums.  Consumers can also call CoverME.gov at 1-866-636-0355; TTY: 711, Monday-Friday, 8 am – 8 pm during the Open Enrollment Period.

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 Connect for Health Colorado:

Connect for Health Colorado Announces ‘Extraordinary’ Number of People Enrolling in Health Insurance for Plan Year 2025

Enrollment is outpacing previous years, and Dec. 15 is the deadline to sign up for coverage that begins Jan. 1, 2025.

Denver, Colo.– Today is Get Covered Colorado Day, a day of action designed to encourage as many Coloradans as possible to enroll in 2025 health insurance during Connect for Health Colorado's annual open enrollment period.

According to Connect for Health Colorado, the state’s official health insurance marketplace, enrollment for plan year 2025 is fast outpacing previous years. Since Nov. 1st, 221,443 residents have enrolled in a health insurance plan. That’s 23% more enrollments than roughly the same time period last year.

via Nevada Health Link:

Over 17,815 Nevadans Enroll Through Nevada Health Link in First Month of Open Enrollment Period

CARSON CITY, Nev. – Open Enrollment through NevadaHealthLink.com began on November 1, and Nevadans are taking action to secure their health coverage for the upcoming new year. In the first month, over 17,815 individuals have actively shopped for and enrolled in plans, demonstrating a strong start to this year’s enrollment period.

Among these enrollees, 7,270 are new to Nevada Health Link, a 10% increase in the number of new enrollees compared to the same period last year. Additionally, 10,545 consumers actively re-enrolled or updated their plans for 2025. In total, Nevada Health Link now provides coverage to over 95,000 Nevadans.

 

Via the American Society of Anesthesiologists:

Anthem Blue Cross Blue Shield Won’t Pay for the Complete Duration of Anesthesia for Patients’ Surgical Procedures

CHICAGO – In an unprecedented move, Anthem Blue Cross Blue Shield plans representing Connecticut, New York and Missouri have unilaterally declared it will no longer pay for anesthesia care if the surgery or procedure goes beyond an arbitrary time limit, regardless of how long the surgical procedure takes. The American Society of Anesthesiologists calls on Anthem to reverse this proposal immediately.

Anesthesiologists provide individualized care to every patient, carefully assessing the patient’s health prior to the surgery, looking at existing diseases and medical conditions to determine the resources and medical expertise needed, attending to the patient during the entire procedure, resolving unexpected complications that may arise and/or extend the duration of the surgery, and working to ensure that the patient is comfortable during recovery.

Earlier this afternoon, the Centers for Medicare & Medicaid Services (CMS) published the second 2025 Open Enrollment Period "National Snapshot" report...and as I noted two weeks ago, at first glance healthcare data junkies might panic at the seemingly low topline numbers:

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!

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 August 2024:

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