Below I'm posting a similar breakout of total ACA Medicaid Expansion enrollment from January 2014 - June 2024, via the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports (warning: That link could be broken or blank by the time you read this under the Trump Administration).
Unfortunately, the MBES reports currently only run through June of last year, so the last half of the year is missing.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.
Click the image for a higher-resolution version. I'm not bothering to include the state labels since some would be too difficult to make out, but it starts with Alaska at the bottom and works its way up to West Virginia at the top (remember, neither Alabama nor Wisconsin or Wyoming have expanded Medicaid under the ACA). It also includes Guam, Puerto Rico and the U.S. Virgin Islands.
There's still likely up to perhaps ~30,000 or so Qualified Health Plan (QHP) enrollments to be added to the 2025 Open Enrollment Period (OEP) tally from the states which haven't reported their final, data (in fact, CA, DC, NJ, NY & RI haven't ended theirs yet), but I decided to throw this together today for the hell of it.
The table below charts the the first twelve years of ACA Open Enrollment Periods, broken out by state. I've also included Basic Health Plan (BHP) enrollment in Minnesota, New York and (new last summer) Oregon, the only states where BHP programs have been implemented to date.
No further analysis or comment here; I just think this is a pretty cool graphic which demonstrates visually how the ACA has grown over time to become firmly embedded into the U.S. healthcare landscape. Source: CMS Marketplace Open Enrollment Period Public Use Files for 2014 - 2024; Semi-final OEP Snapshot Report for 2025 (along with some nominal updates from a few of the state-based exchanges):
Connect for Health Colorado Sets a New Record: 282,483 People Enrolled in Health Insurance for Plan Year 2025
Denver, Colo. – Connect for Health Colorado, the state’s official health insurance marketplace, announced today a record 282,483 Coloradans have enrolled in health insurance for plan year 2025, with 80% receiving financial assistance to reduce the cost of their premiums.
The total number of people who enrolled in health insurance plans for 2025 is 19% higher than the number who enrolled in 2024.
Over 110,000 Nevadans got enrolled, marking the largest enrollment in the history of Nevada’s marketplace
CARSON CITY, Nev. – Nevada Health Link has achieved a historic milestone this year with its record-setting Open Enrollment Period for Plan Year 2025. With over 110,000 Nevadans enrolling in affordable and comprehensive health and dental coverage through the state-based marketplace, this achievement underscores the critical importance of providing accessible and affordable health insurance options to Nevadans across the state.
“Reaching the highest enrollment numbers in Nevada Health Link’s history is a milestone we’re incredibly proud of,” said Russell Cook, Executive Director of Nevada Health Link. “Health insurance is more than just a safety net in case of a medical emergency – it's peace of mind, financial security, and, ultimately, a pathway to better health outcomes for individuals and families across our state. This record-setting enrollment underscores the importance of our mission to prioritize the well-being of Nevada’s communities.”
Vulnerable House Republicans warn leaders against cutting Obamacare
The group of centrists also said the party needed to be careful about deep cuts to social safety net programs.
House Republicans in competitive districts warned GOP leaders Thursday: We could lose our seats if you gut Obamacare to pay for a massive border, energy and tax bill.
A group of about a dozen centrist Republicans...worry GOP efforts to pare back the Affordable Care Act could pour fuel on the fire.
...Instead, they argued, Republicans needed to embrace the GOP’s role as the working class party. Leaders would counter that message by slashing programs working Americans rely on, they said. GOP lawmakers in the room included Rep. Brian Fitzpatrick (Pa.), Young Kim (Calif.), David Valadao (Calif.), Andrew Garbarino (N.Y.), Tom Barrett (Mich.) and Don Bacon (Neb.).
Health care spending in the US reached $4.9 trillion and increased 7.5 percent in 2023, growing from a rate of 4.6 percent in 2022. In 2023, private health insurance and Medicare spending grew faster than in 2022, while Medicaid spending and enrollment growth slowed as the COVID-19 public health emergency ended. The health sector’s share of the economy in 2023 was 17.6 percent, which was similar to its share of 17.4 percent in 2022 but lower than in 2020 and 2021 during the height of the COVID-19 pandemic.
A flurry of scientific gatherings and panels across federal science agencies were canceled on Wednesday, at a time of heightened sensitivity about how the Trump administration will shift the agencies’ policies and day-to-day affairs.
Several meetings of National Institutes of Health study sections, which review applications for fellowships and grants, were canceled without being rescheduled, according to agency notices reviewed by STAT. A Feb. 20-21 meeting of the National Vaccine Advisory Committee, a panel that advises the leadership of the Department of Health and Human Services on vaccine policy, was also canceled. So was a meeting of the Presidential Advisory Council for Combating Antibiotic-Resistant Bacteria that was scheduled for Jan. 28 and 29.
The scope of the cancellations was unclear. It was also unclear whether they were related to the Trump administration’s freeze on external communications until Feb. 1.
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:
On his first day in office, Donald Trump issued dozens of Executive Orders. Some of these are mostly symbolic; some won't have any effect without legislative action; some are blatantly unconstitutional & are already being challenged in court. Many, however, are terrifying and will have horrific consequences for thousands or potentially millions of Americans and non-Americans alike.
Along with issuing his own new ones, Trump has also already rescinded over 60 XOs issued by President Biden. In this post I'm going to focus on three of them which pertain specifically to healthcare policy.
Again, all three of the following have now been RESCINDED BY DONALD TRUMP:
US exit from WHO could see fifth of budget disappear
US President Donald Trump has signed an executive order to begin the process of withdrawing the US from the World Health Organization (WHO).
"Oooh, that's a big one," the newly inaugurated US president said as he approved the document after arriving back at the White House. It was one of dozens of executive actions he put his signature to on day one in office.
...Under the Biden administration the US continued to be the largest funder of the WHO and in 2023 it contributed almost one-fifth of the agency's budget.
The organisation's annual budget is $6.8bn (£5.5bn).
It is possible that funding could disappear almost immediately, and it is not clear that other nations will step up to fill the gap.
A US withdrawal could have an impact on WHO's ability to respond to emergencies such as an Ebola outbreak, or MPOX – let alone another Covid-19-style pandemic.
