A week or so ago the Centers for Medicare & Medicaid Services (CMS) issued a semi-final 2025 ACA Open Enrollment Period report, which noted that 23.6 million Americans had selected 2025 plan year coverage via the various ACA marketplaces since November 1st...as of either January 4th or December 28th, depending on the state.
Those thru dates are important, of course, because the 2025 OEP was still ongoing in every state except Idaho at the time...and in fact it's still going on in several of them, including CA, DC, MA, NJ, NY, RI & VA. In some of these states the final deadline is still up to 2 weeks away.
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:
SACRAMENTO, Calif. — Covered California has announced a special-enrollment period for residents of Los Angeles and Ventura counties, where a state of emergency has been declared due to the Palisades and Eaton Fires that have destroyed over 12,000 homes and displaced hundreds of thousands of Californians.
“These fires have caused unprecedented destruction and have upended the lives of so many living in Southern California,” said Covered California Executive Director Jessica Altman. “Everyone who is uninsured and has been affected by these fires, directly or indirectly, will have an extended opportunity to obtain health insurance through Covered California or Medi-Cal over the next two months.”
Californians have 60 days from the date that the state of emergency was declared in their county to sign up for coverage, so this special-enrollment period will last until March 8.
Other resources made available to Californians affected by the fires can be found here:
The biggest program on the hit list, however, is Medicaid, which would make up nearly half of the $5 TRILLION in budget cuts Republicans have in mind in order to pay for...massive tax cuts for corporations & the wealthy, of course.
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:
In October 2024, 79.3 million individuals were enrolled in Medicaid and CHIP.
72.1 million individuals were enrolled in Medicaid, and 7.2 million individuals were enrolled in CHIP.
41.7 million adults were enrolled in Medicaid, and there were 37.6 million Medicaid child and CHIP enrollees.
Medicaid and CHIP Applications Received
In October 2024, Medicaid, CHIP, Human Services agencies, and State-based Marketplaces received 2.6 million applications, or 2 percent more applications, as compared to September 2024.
The number of applications received has increased by 20 percent since October 2023 and increased by 66 percent since October 2022.
Total Medicaid/CHIP enrollment in October 2024 still dropped very slightly from September...by just 55,000 people.
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:
Number of People Who Have Ever Enrolled in ACA Marketplace Coverage, 2014-2024
The Affordable Care Act (ACA) created Health Insurance Marketplaces in all states starting in 2014. Eligible partcipants can purchase individual health insurance plans in the ACA Marketplaces, and qualifying individuals can receive Premium Tax Credits (PTC) to help offset the cost of coverage. The PTC was expanded in both generosity and eligibility startng with the American Rescue Plan Act in 2021, with these enhancements extended in the Inflaton Reducton Act in 2022. The ACA Marketplaces enable Americans to purchase comprehensive, affordable health insurance that they may not have access to through their employers or through programs such as Medicare or Medicaid, including when they experience brief or longer-term gaps in the availability of other coverage.
The Affordable Care Act includes a long list of codified instructions about what's required under the law. However, like any major piece of legislation, many of the specific details are left up to the agency responsible for implementing the law.
While the PPACA is itself a lengthy document, it would have to be several times longer yet in order to cover every conceivable detail involved in operating the ACA exchanges, Medicaid expansion and so forth. The major provisions of the ACA fall under the Department of Health & Human Services (HHS), and within that, the Centers for Medicare & Medicaid (CMS)
Every year, CMS issues a long, wonky document called the Notice of Benefit & Payment Parameters (NBPP) for the Affordable Care Act. This is basically a list of proposed tweaks to some of the specifics of how the ACA is actually implemented for the following year.
Massachusetts residents have [9] days of Open Enrollment remaining, with the window for enrolling in health insurance through the Health Connector closing on Jan. 23.
Open Enrollment started Nov. 1 and is when anyone who needs health insurance can get covered through the Health Connector. The Jan. 23 state deadline is later than the federal government’s Jan. 15 deadline.
“Massachusetts requires everyone to have health insurance, so if you don’t have coverage, now is the time to enroll,” said Audrey Morse Gasteier, the Executive Director of the Massachusetts Health Connector. “The Health Connector provides help paying for coverage for many people, which means residents can get a plan that gives them access to the care and services they need. We are here to help enroll anyone without health insurance so they can kick off the new year with the peace of mind that comes with affordable, high-quality health coverage.”
