The 2025 ACA Open Enrollment Period (OEP) officially begins on November 1st.
This is the best OEP ever for the ACA for several reasons:
The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;
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;
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.
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:
Last week I reposted a press release & video from the Rhode Island Dept. of Administration explaining the details of a major security breach of the state's social services system.
Today it looks like the issue was a lot worse than I thought. via WPRI:
On Monday, Gov. Dan McKee said his team has identified 650,000 people whose personal information was stolen in the recent cyberattack on the state’s IT system for social services.
Yikes. FWIW, Rhode Island only has around 1.1 million people, so this basically means that 60% of the entire state population has had their personal info compromised.
...Earlier this month, the cyberattack shut down the state’s IT system known as RIBridges, which serves as an eligibility database for a host of social services, such as SNAP and Medicaid, along with subsidized health insurance through HealthSourceRI.
With Open Enrollment going on now through Nevada’s official health insurance marketplace known as NevadaHealthLink.com, there are less than two weeks left for Nevadans to get coverage starting the first of the new year. Nevadans must enroll in a plan by 11:59 p.m. on December 31, 2024, for their health insurance coverage to be effective starting January 1, 2025.
Those who don’t enroll by December 31 will still have a chance to enroll in coverage through January 15, 2025, however, those who enroll between January 1 and January 15, 2025, will have coverage beginning February 1, 2025.
Open Enrollment began on November 1 and since then, over 30,000 Nevadans have actively enrolled in a plan, with 15,236 being new to enroll on Nevada Health Link. The Open Enrollment Period is the only time of year Nevadans can freely enroll in a health insurance plan through NevadaHealthLink.com without experiencing a qualifying life event, such as getting married, having a baby or moving.
Not only is New Mexico's exchange enrollment up a whopping 29% vs. the same point last year, it's actually already 15% higher than the 2024 OEP's final total of 56,472!
Now that the two largest ACA marketplaces (HealthCare.Gov, which hosts 31 states, and Covered California) have joined a half-dozen other states in posting fairly recent 2025 Open Enrollment Period updates, I figured it would be a good time to take a look at where things stand ahead of the big holiday break.
Across 38 states, a total of around 19.5 million people have selected Qualified Health Plans (QHPs) via either the federal or state-based exchanges as of anywhere from 12/05 - 12/18. Collectively, this is roughly 16.6% higher than the same/nearly the same dates a year ago. It's important to remember that Georgia moved from the federal exchange to its own state-based marketplace this year, which is why ~1.2 million enrollees have been subtracted from the 2024 HC.gov total. Note that the HC.gov numbers are rounded off to the nearest 100K, per CMS's press releases both years.
Covered California Hits Record Enrollment Before its First Key Open Enrollment Deadline on Dec. 31
SACRAMENTO, Calif. — Covered California has surpassed 1.8 million enrollees, reaching its record-high enrollment with over a week until the first open enrollment deadline on Dec. 31.
This open enrollment, 143,686 Californians have signed up for 2025 coverage as of Dec. 14, marking a 3 percent increase over the same period last year.
Another 1,647,162 Californians have renewed their coverage so far, a 4 percent increase over the same period last year.
Combined, that's 1,790,848 Californians who have selected ACA exchange coverage for 2025. Taking the percents above literally that would mean CA had ~1,723,311 QHP selections thru 12/14/23 last year (up 3.9% overall).
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:
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:
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:
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.
