Charles Gaba's blog

On Christmas Day, as you may recall, a "Treemap" graph which had originally been published 2 weeks earlier in a Reuters article went viral on social media. It was then republished by Newsweek, again without any context provided.

The graph purported to break out "Obamacare applications by state for 2025" by states which voted for Donald Trump vs. those which voted for Kamala Harris in November 2024. Here's what it looked like:

As I noted at the time, this graph was technically accurate...while simultaneously being jaw-droppingly misleading, for several reasons, including:

A week or so ago I expressed surprise and disappointment over an incredibly misleading headline from KFF, declaring "Obamacare sign-ups lag after Trump election and legal challenges." In fact, as I noted on December 23rd, I noted, 2025 ACA Open Enrollment was actually running over 16% ahead of roughly the same point a year earlier:

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.

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 Access Health CT:

Customers who enroll on or before Jan. 15, 2025 will have coverage beginning Feb. 1, 2025

HARTFORD, Conn. (Jan. 6, 2025) — Access Health CT (AHCT) today announced the deadline to enroll in health and dental coverage starting Feb. 1, 2025 is Jan. 15, 2025. This is the final deadline for the 2025 Open Enrollment Period. 

The Open Enrollment Period for Connecticut residents to shop, compare and enroll in health insurance or renew their coverage began Nov. 1, 2024. Customers may enroll in either health or dental coverage, or both.

AHCT is the only place state residents can get financial help to pay for their health insurance. Nearly 90% of customers received financial assistance last year. Some customers might qualify for the Covered CT Program. This program provides no-cost coverage for eligible residents.

BeWell NM, New Mexico's ACA exchange, has an Open Enrollment Dashboard updated weekly:

As of Jan. 5th, 2025:

  • Auto-Reenrollments: 38,124
  • Active Enrollments: 20,282
  • New Enrollments: 7,463
  • TOTAL: 65,869

What's more noteworthy is that when compared against the same point last year, New Mexico's 2025 ACA enrollment total is dramatically higher.

Not only is New Mexico's exchange enrollment up a whopping 28% vs. the same point last year, it's actually already 16.6% higher than the 2024 OEP's final total of 56,472!

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:

I don't want to get out over my skis here; a single Senator saying that she supports something in an interview is a far cry from them actually voting to do so, especially when you'd need several more members of both the House and Senate (including the leadership of both chambers) to even hold that vote.

Even so, this is still a pretty significant development, given how thin the odds are of the improved subsidies included by the IRA getting extended are at the moment.

This is from an interview with Alaska GOP Senator Lisa Murkwoski published by the Alaska Beacon yesterday:

Nathaniel Herz: On the specific issue of the enhanced tax credits for the premiums for the individual marketplace health insurance plans — it seems like there is a real question about whether those continue...

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:

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