January 2026

via NV Health Link:

104,286 Nevadans Enrolled in Health Insurance During 2026 Plan Year Open Enrollment

More Nevadans actively engaged in their health coverage this year, with 10% enrolled in the new public option, known as the Battle Born State Plans

CARSON CITY, Nev. – Nevada Health Link’s Open Enrollment Period for Plan Year 2026 concluded on January 15 with 104,286 Nevadans enrolling in comprehensive health coverage through the state-based marketplace, including the new Battle Born State Plans, which accounted for 10% of total enrollments. Of the 104,286, there were 63,563 Nevadans who actively shopped, showing a 32% increase in engagement of active enrollments from last year’s Open Enrollment.

Awhile back I reported that Access Health CT, Connecticut's ACA exchange, was planning on joining several other states including California, Colorado, Maryland, New Jersey & New Mexico in offering supplemental subsidies to partially (or, in the case of New Mexico, fully) backfill the lost federal tax credits for ACA enrollees, as well as extending the final Open Enrollment deadline for February coverage through the end of January.

A few weeks later they announced how th state subsidies will be structured:

...The state subsidies will fully fund the expired enhanced premium tax credit amounts for consumers with incomes between 100-200% of the federal poverty level and who are not enrolled in the Covered CT program.

Me, December 26th:

...I'm bringing all of this back up again today because I strongly suspect that the situation is about to reverse itself, with the Trump Administration already preparing to brag about impressive-sounding ACA enrollment numbers for 2026 in spite of the enhanced tax credits expiring less than 60 hours from now...even though the actual negative impact of the expiring tax credits (along with several other administrative policy changes made by CMS this year) likely won't be known for several months after Open Enrollment officially ends in January.

So, this morning I learned that the Massachusetts Health Connector has recently launched a very handy Tableau-based enrollment dashboard which looks similar to the one rolled out by the New Mexico exchange awhile back.

This is very helpful for data hounds like myself, and I'll be consulting it regularly in the future.

In addition to displaying the latest enrollment data by various criteria, the MA dashboard also provides data from prior weeks, which means I can look for trend lines:

Total QHPs (ConnectorCare + Std. QHPs combined):

• 12/14/25: 361,541
• 12/21/25: 361,192
• 12/28/25: 371,453
• 01/04/26: 368,436
• 01/11/26: 372,971

What's noteworthy about this is that yesterday's CMS report had Massachusetts down as having 382,580 QHP selections total as of 12/27/25...which is over 11,000 higher than what the MA Connector had it at as of a day later.

Monday, January 12th, 4:45am, via Jordain Carney of Politico:

[GOP Sen. Bernie Moreno of Ohio] said his goal is to get roughly 35 of the Senate’s 53 GOP senators to support an eventual deal — not just a handful joining Democrats on a “defection vote” — and that he’s keeping the White House and Senate leaders closely apprised of the discussions.

...His involvement is also a sign that a new generation of bipartisan dealmakers might be starting to emerge after some of the Senate’s old hands headed for the exits in recent cycles. Moreno is now in close touch with not only Collins and Shaheen but other Senate pragmatists such as Tim Kaine (D-Va.), Lisa Murkowski (R-Alaska) and Angus King (I-Maine).

...The Senate group’s proposed extension would include new restrictions including a $5 a month minimum premium payment and an income cap set at 700 percent of the federal poverty level. In the second year, the proposal would also give enrollees to take their subsidy as cash in pre-funded health savings accounts — an arrangement favored by Trump.

The Centers for Medicare & Medicaid Services (CMS) just published the second official 2026 Open Enrollment Period snapshot report:

The Centers for Medicare & Medicaid Services (CMS) reports that 22.8 million consumers have signed up for 2026 individual market health insurance coverage through the Marketplaces since the start of the 2026 Marketplace Open Enrollment Period (OEP) on November 1, 2025. This includes 15.6 million Marketplace plan selections in the 30 states using the HealthCare.gov platform for the 2026 plan year and 7.2 million plan selections in the 20 states and the District of Columbia with state-based Exchanges (SBEs) that are using their own eligibility and enrollment platforms.

Total nationwide plan selections include 2.8 million consumers who are new to the Marketplaces for 2026, and 20.0 million consumers who had active 2025 coverage and selected a plan for 2026 coverage or were automatically re-enrolled.

Yesterday, the U.S. House of Representatives finally voted on a clean, 3-year extension of the enhanced ACA tax credits which had been in place for the prior five years, and which over 22 million Americans (myself included) were relying on to keep their health insurance premiums at affordable levels until they expired at the end of December 2025.

In the end, 17 House Republicans voted with all 213 House Democrats to extend the improved tax credit formula through the end of 2028. Thirteen of the seventeen GOP "Yea" votes represent swing districts (the remaining four were Maria Elvira Salazar in FL-27, Andrew Garbarino of NY-02, David Joyce of OH-14 and Monica DeLa Cruz of TX-15).

As expected, just moments ago the House of Representatives voted to extend the enhanced ACA tax credits for another 3 years, through the end of 2028, with no strings attached...with a whopping 17 House Republicans crossing over to vote for it.

This is actually slightly higher than my prediction yesterday that up to 16 total House Republicans would vote for it, I should note!

I'm going to assume it will end up narrowly passing the House; it would be pretty stupid for those four to sign the discharge petition without actually voting for the bill, and Republicans are currently down 2 members anyway with Marjorie Taylor Greene (GA) having resigned and Doug LaMalfa (CA) dying yesterday morning.

My guess is that up to a dozen of the other vulnerable GOP House members will also vote for the bill once it breaks a simple majority, but we'll see.

This just out from the Congressional Budget Office (CBO) ahead of today's final House vote on a "clean" 3-year extension of the enhanced ACA tax credits:

H.R. 1834 would authorize an extension through 2028 of the premium tax credit structure provided in the American Rescue Plan Act of 2021 and later extended through calendar year 2025 by the 2022 reconciliation act. The advanceable and refundable premium tax credit reduces out−of-pocket costs for the premiums enrollees pay for health insurance obtained through the marketplaces established by the Affordable Care Act.

Budget-wise, the CBO is pegging a 3-yr extension at costing around $80.6 billion net (they had previously pegged a 10-yr extension at ~$350B, but that assumes 10 years of inflation/etc as well).

via Covered California's Open Enrollment Dashboard, as of January 3rd:

• New enrollments: 163,023
• Active renewals: 509.526
• Passive Autorenewals: 1,252,350
• Total: 1,924,899

As of the same point last year (actually 1 day more; the data from last year is as of 12/28), Covered CA was reporting:

• New enrollments: 235,573
• Active renewals: 425,700
• Passive/Autorenewals: 1,241,745
• Total: 1,903,018

Now that we're past the deadline for January coverage, I can start including auto-renewals as well. Overall...

This is long overdue, I realize, but I've finally decided to stop posting links to ACASignups.net on Twitter/X, period.

I made the decision to stop posting there a few times in the past--when Elon Musk first took over the platform; when he made "verified accounts" meaningless; and most recently, when he performed a Nazi salute on stage.

Each time, however, a few days later I would always convince myself that the positive I was doing by keeping more people informed about the latest developments in U.S. healthcare policy outweighed the negative of continuing to post there.

The other reason I kept cross-posting blog links was more about the data nerd in me: For over a decade I've tracked the traffic to this website across different platforms, and Twitter was always a major part of that, so I wanted to see it through, at least until I reached a natural stopping point.

You can certainly question my logic on both of these rationalizations until now, of course, but that's where my mind was at.

So what's changed?

A few weeks ago I reported that Access Health CT, Connecticut's ACA exchange, was planning on joining several other states including California, Colorado, Maryland, New Jersey & New Mexico in offering supplemental subsidies to partially (or, in the case of New Mexico, fully) backfill the lost federal tax credits for ACA enrollees.

Connecticut will spend $70 million to partly offset the looming loss of $295 million in enhanced federal tax credits that subsidize health insurance premiums for tens of thousands of residents under the Affordable Care Act, Gov. Ned Lamont said Thursday.

Using emergency authority granted him by the General Assembly in special session last month, the governor announced the commitment minutes after the U.S. Senate failed to advance either a Democratic proposal to extend the credits or a Republican alternative.