Speaker Johnson, Leader Jeffries, Leader Thune, and Leader Schumer,
We urge you to extend the Affordable Care Act’s enhanced premium tax credits. For millions of hard-working Americans, these subsidies are the only reason health insurance is still within reach in a country where the cost of living keeps going up.
If they expire, premiums will rise by thousands of dollars for many families, millions will lose coverage, and people will be forced to make impossible choices between paying for healthcare, rent, or groceries. Hard-working American families, older Americans not yet on Medicare, small business owners, and rural communities—where marketplace coverage is often the only option—will be hit the hardest.
SACRAMENTO, Calif. — Covered California issued the following statement concerning the California Department of Public Health (CDPH) announcement of official immunization recommendations, following the passage of Assembly Bill 144:
“We applaud Gov. Newsom, the California Legislature and the Department of Public Health for recommending immunizations that are backed by scientific research and supported by trusted medical organizations,” said Covered California Executive Director Jessica Altman. “The evidence overwhelmingly shows that vaccines work, and with these steps Californians – and all Covered California enrollees – will continue to have access to these critical health tools.”
...the good news is that the [U.S. Preventative Services Task Force] can continue to do its job. The bad news is that anti-vaxxer & complete nutjob Robert F. Kennedy Jr. is now the one who gets to decide who serves on the PSTF.
The Task Force is made up of 16 volunteer experts in the fields of preventive medicine and primary care, including internal medicine, family medicine, pediatrics, behavioral health, obstetrics/gynecology, and nursing. Most of our members are practicing clinicians. To develop recommendations, we use our own expertise and routinely invite the input of disease experts and specialists. We also invite input from stakeholders and the public.
(I know numerous other states with Democratic governors have issued similar executive orders already, but I'm a lifelong Michigander as are most of my family so this one comes as particular relief to me)...
via email (no link yet):
Governor Whitmer Signs Executive Directive, Ensuring Michiganders Can Access Vaccines to Stay Healthy Ahead of Cold, COVID-19, and Flu Season
LANSING, Mich.—Today, Governor Gretchen Whitmer signed an executive directive, ensuring vaccines remain available to Michiganders as we approach the fall. Specifically, she has instructed state agencies to identify and remove any barriers to accessing COVID-19 vaccines, so Michiganders can stay healthy ahead of cold and flu season. Governor Whitmer remains committed to supporting the health and wellbeing of every Michigander and their families.
I just finished writing up a deep dive into the Arkansas Insurance Dept's move from laissez faire-style Silver Loading to fully-regulated & maximized Premium Alignment in an attempt to mitigate the massive net premium damage about to be caused if the enhanced ACA premium tax credits expire at the end of 2025.
However, it's not just Arkansas which has finally seen the light and joined about a dozen other states in putting full-bore Premium Alignment (PA) pricing into place to help reduce the financial burden on ACA individual market enrollees in 2026.
Other states which have already done so in the past include Colorado (sort of), Texas, New Mexico, Maryland, Pennsylvania (somewhat), Illinois, Vermont and Wyoming.
Warning: This isn't just gonna get deeply wonky, it also requires digging deep into histroy. You've been warned.
Chapter 1: The (simplified) Backstory:
The ACA includes two types of financial subsidies: Advance Premium Tax Credits (APTC), which reduce monthly premiums; and Cost Sharing Reductions (CSR), which cut down on deductibles, co-pays & other out-of-pocket (OOP) expenses for low-income enrollees.
In 2014, then-Speaker of the House John Boehner filed a lawsuit on behalf of Congressional Republicans against the Obama Administration, in part because they claimed that CSR payments were unconstitutional because they weren't explicitly appropriated by Congress in the text of the Affordable Care Act.
A long legal process ensued, the end of which resulted in a federal judge ruling in the GOP's favor and ordering that CSR payments stop being made...but also staying that same order pending appeal of her decision by the Justice Department (then still run by the Obama Administration).
(sigh) So, moments ago I received the following press release from the Centers for Medicare & Medicaid Services (CMS):
Today, the Centers for Medicare & Medicaid Services (CMS) unveiled details on how states can apply to receive funding from the $50 billion Rural Health Transformation Program created under the Working Families Tax Cuts Act to strengthen health care across rural America. This unprecedented investment is designed to empower states to transform the existing rural health care infrastructure and build sustainable health care systems that expand access, enhance quality of care, and improve outcomes for patients.
Amusingly (and sadly), the link itself goes to the WhiteHouse.Gov page describing not the "Working Families Tax Cuts Act" (which doesn't exist) but rather the so-called "One Big Beautiful Bill Act" which is what Trump and Republicans insisted on calling it for months, right up until they realized that it's about as popular as a turd in a punchbowl, at which point they decided that simply rebranding it as a "tax cut" for "working families" will solve all their problems at the midterms next year.
If you've been following my state-by-state 2026 avg. rate change project, you may have noticed that after filling in the final, approved rate filings for a bunch of states over the past month or so, these tapered off to just three more last week (Illinois, Washington and Connecticut).
California has ~1.98 MILLION residents enrolled in ACA exchange plans, over 88% of whom are currently subsidized. They also have an estimated ~470,000 off-exchange enrollees. Combined, that's over 2.4 million people, or 6.2% of their total population.
