Quick ACA Update: More than 15.6 million Americans have enrolled in a plan on the federally run exchanges so far — compared to roughly 16 million Americans last year.
Notably, this small drop follows several important CMS actions over the past year to combat fraudulent and improper enrollments, which have already removed more than enough people from premium subsidies who are covered elsewhere to account for the modest enrollment change. That said, there is a politically motivated lawsuit that has paused critical actions to make sure Biden-era improper enrollments are fully knocked out.
IMPORTANT NOTE: For those who need insurance and have not already signed up — go to HealthCare.Gov to see if you qualify and what types of plans you can get. Most Americans can access a plan for $21 a month!
Denver, Colo.– Enrollment for health coverage beginning Jan. 1 is consistent with this time last year, Connect for Health Colorado announced today. 256,422 residents have enrolled in a health insurance plan through the state’s official health insurance marketplace. That is approximately 0.14% higher than the number of people who enrolled for Jan. 1 coverage last year.
Connect for Health Colorado is the only place where Coloradans can get financial help to purchase health insurance, and an estimated 65% of customers will qualify for financial help for plan year 2026. More than half – 58% – of customers who currently receive financial assistance will have at least one 2026 plan option with an estimated net premium under $10 per month.
Covered California is encouraging all uninsured Californians to sign up for health insurance by Dec. 31.
The open-enrollment period for 2026 ends on Jan. 31, but to have insurance in place for January, consumers need to enroll by the end of the year. Covered California’s over 1.9 million enrollees also have until Dec. 31 to make any changes to their coverage for next year.
It has been a unique open enrollment with the Enhanced Premium Tax Credits set to expire heading into 2026. Since their introduction in 2021, the enhanced assistance has helped double enrollment nationally under the Patient Protection and Affordable Care Act and by over 23 percent in California.
So far this open enrollment, 123,461 Californians have signed up for 2026 coverage as of Dec. 20, marking a 30 percent decrease over the same period last year.
Yesterday I corrected a bunch of factual misstatements (aka "lies") and gross exaggerations about the ACA's premium tax credits and the GOP's refusal to extend the enhanced subsidy formula made by Oklahoma Senator James Lankford in his appearance on CNN's State of the Union with host Kasie Hunt.
Today, I'm addressing the most critical exchange of his appearance:
LANKFORD: "I would tell you uh healthcare in 2010 before Obamacare kicked in. Healthcare in 2010 the normal premium was $215. $215. Now take what it is now after Obamacare has been put in place and I think the..."
HUNT: "...Right, but insurance companies could could refuse to cover you for a pre-existing condition. I mean the health care system was vastly different before Obamacare for for many of those reasons."
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 September 2025:
Total Medicare beneficiaries are up to 69.36 million (up ~77K month over month)
Traditional/FFM Medicare beneficiaries are at 33.79 million (flat m/m)
Medicare Advantage beneficiaries reached 35.57 million (up ~77K m/m)
12.12 million Medicare enrollees (around 17.5% of the total) were "Dual Eligibles"...that is, enrolled in both Medicare and Medicaid.
The only number which seems odd is the 384K increase in Dual Eligibles...I'm not sure what to make of that.
According to the new report, total enrollment from December 2024 through March 2025 only dropped slightly (just over 30,000 people, or just 0.14%), and remained at over 20.7 million nationally, so it doesn't look like the Trump Admin has started cooking these particular books, at least not yet.
I've been able to cobble together more recent ACA expansion enrollment for about half of the 40 states (+DC) which participate in the program; since March, expansion enrollment has dropped in some states but is actually up in some others. It remains remarkably stable so far, although this is going to change radically with the draconian provisions of the GOP's Big Ugly Bill starting to kick in soon.
Yesterday morning on CNN's "State of the Union," host Kasie Hunt talked to Oklahoma GOP Sen. James Lankford about the enhanced ACA tax credits which are currently scheduled to expire exactly 10 days from now.
This gets into the weeds a bit, so I'm breaking it into two separate posts; I'll be publishing the second part tomorrow.
The crux of the CNN appearance was Langford claiming that "Obamacare" (the Affordable Care Act...guys, he's been out of office for nearly 9 years now, let it go willya?) "caused prices to skyrocket in the marketplace" and that the expiration of the enhanced tax credits put into place in 2021 during the COVID pandemic is simply "exposing the real issues" within the ACA.
First of all, let's clear up this "they were only put in place due to the COVID pandemic" talking point which Republicans keep tossing around (the implication being that since the COVID pandemic is over, the subsidy upgrade should end as well).
Get it straight: Eliminating the 400% FPL subsidy cliff and beefing up the tax credit formula is something which Democrats always intended to do when they had the ability to do so.
ST. PAUL, Minn. — Minnesotans have until January 15, 2026, to sign up for 2026 health insurance through MNsure. While the first enrollment deadline has passed, consumers can still go to the MNsure website to find a plan and sign up for coverage that starts February 1. The final deadline to enroll is 11:59 p.m. on Wednesday, January 15.
Financial help for Minnesota health care plans is still available only through MNsure. MNsure-certified brokers and navigators provide free expert help and enrollment advice—from trusted professionals who won’t try to upsell consumers.
“MNsure offers a variety of plans that meet Minnesotans’ needs and budgets,” said MNsure CEO Libby Caulum. “As the official health insurance marketplace, MNsure is the best place to shop for a plan you can trust, without fear of scams or false promises.”
BOSTON—The Massachusetts Health Connector’s New Year deadline is looming, with residents without health coverage having until Dec. 23 to enroll in affordable, comprehensive health insurance that starts Jan. 1, 2026.
Most people who apply for health insurance through the Health Connector get help paying for their coverage through the ConnectorCare program. The Health Connector is the state’s health insurance Marketplace, the only place where residents can get help paying for their coverage, and where residents can be assured they are getting a comprehensive health plan they can count on and avoid the junk plans that lurk on search engines.
As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which was December 15th in most states, but not until 12/23 in MA & 12/31 in CA, IL, MD, NV, NJ, NM, PA, RI & VA).
More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.
In California, those come to 535,349 combined. This also means that only 23% of current enrollees had actively re-enrolled as of 12/13.
As of the same point last year (actually 1 day more; the data from last year is as of 12/14), Covered CA was reporting:
