Charles Gaba's blog

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:

via the Centers for Medicare & Medicaid Services (CMS):

August 2024 Key Findings

Medicaid and CHIP Enrollment

• In August 2024, 79.4 million individuals were enrolled in Medicaid and CHIP.
  • 72.3 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
  • 41.8 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.

Medicaid and CHIP Applications Received

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 CoverME.gov:

Plan Selection Snapshot

The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.  

Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2025. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin insurance. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.   

The deadline to select a plan for coverage beginning January 1, 2025 is December 15, 2024. Consumers who select a plan between December 16, 2024 and January 15, 2025 will have coverage beginning February 1, 2025.