I have little to add to the discussion this morning, so I'll just repost this tweet by a Wall St. Journal health reporter:

Almost half the states have laws in place or at the ready to curtail or outlaw abortion, including 13 states with trigger laws in place that will ban it immediately.

— Alex Janin (@AlexLJanin) June 24, 2022

America is in a very, very dark place right now.

Once again, here's what the Affordable Care Act's premium subsidy tables look like under the original ACA itself and under the American Rescue Plan (ARP). The premium caps are the maximum percent of household income which a household has to pay for the benchmark Silver plan at various income ranges.

The ARP table is currently scheduled to sunset at the end of December, at which point, without legislation passing Congress & being signed into law by President Biden, it will revert back to the original ACA subsidy table:

As always, here's my methodology:

Remember: "Decile" means 1/10th or 10% of the total population (all 50 states + DC).

(sigh) The Sword of Damocles continues to dangle over the head of the Affordable Care Act. This time it isn't about an existential threat to the PPACA, at least...but the expanded/enhanced subsidies which were put into place temporarily by the American Rescue Plan (ARP) are definitely at risk.

Just a week or so ago, things were looking promising...

Conversations are underway between Joe Manchin III, D-W.Va., and Senate Majority Leader Charles E. Schumer to negotiate a budget reconciliation bill, which would require only a simple majority for passage, that would meet Manchin’s demands without losing support from other Democrats.

...Another Manchin condition is that the measure avoid any “cliffs” that sunset new programs early to keep the price tag down, something Manchin argues artificially hides the true costs since programs will prove too popular not to extend.

No, this is not a repeat, though it may sound like it. From March:

Since the collapse of the Build Back Better Act in the U.S. Senate last December (reminder: It passed the House but came to a screeching halt when all 50 Republican Senators along with conservative Democrat Joe Manchin refused to support it), Congressional Democrats have been quietly trying to put at least some of the pieces of the bill back together in an attempt to salvage something out of President Biden's signature social spending agenda.

...One of the other provisions of BBB which some members of Congress are trying to save has been reintroduced as a standalone bill in both the House (H.R. 6833) and Senate (S.3700), the Affordable Insulin Now Act.

The AINA does two simple (but important) things:

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS) announced that during the Biden-Harris Administration 253,000 parents have gained access to 12 months of postpartum coverage through Medicaid and Children’s Health Insurance Program (CHIP) extensions. President Joe Biden and Vice President Kamala Harris have made addressing the maternal mortality and morbidity crisis a key priority for their Administration.

BeWellNM Logo

This just in via BeWellNM:

BeWellnm Announces Operational Changes to Aid Leadership Transition

Albuquerque, N.M. (June 16, 2022) – BeWellnm, the New Mexico Health Insurance Exchange, announces operational updates as the state prepares for a successful 2023 Open Enrollment Period in the fall. As beWellnm begins its search for a permanent CEO, it has contracted with GetInsured, the nation’s leading provider of health insurance exchange technology and customer service solutions for health and human services agencies, to provide consultative and operational support during the period of transition. The organization will provide temporary, interim operational leadership for a 10-month period and offer strategic oversight and direction to beWellnm, along with long-term recommendations for maintenance and operations.

Washington State

I don't write about specific state insurance commissioners very often. The main ones which come to mind are:

In all three cases, the commissioners in question were Republicans.

Rhode Island

No formal press release from the Rhode Island Insurance Dept. yet, but according to the SERFF database, here's the preliminary rate filings for 2023 for their individual & small group markets.

Blue Cross Blue Shield of Rhode Island:

CY 2021 Experience Period
We did not adjust the 2021 experience period for Covid‐19. We also did not make any adjustments due to the end of the expanded federal subsidies under the American Rescue Plan Act (ARPA) or the end of the federal public health emergency.

CY 2023 Projection Period
We included a Covid‐19 factor in Other to adjust CY 2023 to reflect a 50% decrease in anticipated Covid‐related spend for the CY 2023 projection period compared to the level in the CY 2021 experience period.

Neighborhood Health Plan of Rhode Island:

via John Wilkerson of Inside Health Policy:

House Speaker Nancy Pelosi (D-CA) said Thursday (June 16) that budget reconciliation legislation might not extend an increase in subsidies for health exchange insurance premiums; the subsidies are needed to avert a spike in Obamacare insurance rates right before the midterm elections.

...When a Punchbowl News reporter asked Thursday about that meeting and whether a reconciliation deal is expected soon, Pelosi’s response was, “It’s alive.”

“There are certain concerns we have about subsidies in the health care bill and the rest, which may or may not be in the negotiations,” she said.

...President Joe Biden included drug pricing reform in an inflation-fighting proposal released over the weekend -- but his plan did not mention the enhanced ACA credits, raising some eyebrows.

..Democrats had counted on drug price controls to pay for the enhanced ACA subsidies, but Manchin recently said the subsidies did not come up in his talks with the White House.

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