The Maryland Health Benefit Exchange has their own Open Enrollment dashboard which, while not providing nearly as much data as New Mexico's, at least breaks out the top-line data. With the 2026 Open Enrollment Period (OEP) now over in the Old Line State, here's what their final numbers look like (barring any last-minute clerical corrections):
Total Renewals: 236,338
New Enrollees: 47,815
Total Enrollments: 255,612
Disenrollments (already subtracted from renewals)
67.4% are subsidized; 32.6% are unsubsidized
They also break out total enrollment by county, which isn't terribly relevant to me.
Final 2025 OEP enrollment in Maryland was 247,243, so this represents a 3.4% QHP selection increase vs. last year, in spite of the enhanced federal tax credits expiring...
Back in September I ran an analysis of the ~24 million Americans enrolled in ACA exchange healthcare coverage to try and get a better idea of the partisan impact of the expiration of the enhanced tax credits.
While it was already common knowledge that red states have significantly more ACA enrollees than blue ones (mainly because 9 of the 10 states still refusing to expand Medicaid under the ACA are red ones), I wanted to take a more granular look, so I broke enrollment out at the Congressional District level instead, and determined that while there are definitely more people in red districts who were about to be hit with massive net premium hikes, it wasn't a massive gap...it was around 20% higher in districts won by Republicans than by Democrats, which is significant but not jaw-dropping.
[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.
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.
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).
Long ago in a galaxy far, far away, during the first batcrap insane 2014 Open Enrollment Period, a common refrain from Republicans looking to attack the newly-ramping up healthcare law was to demand "BUT HOW MANY HAVE PAID???"
The gist of the attack on the ACA was that after the worst of the ugly technical problems experienced by HealthCare.Gov and many of the state-based exchange websites were resolved, there was indeed a rush of backed-up demand to enroll in healthcare coverage by millions of people, but that just because a lot of people signed up for insurance coverage via the exchanges, that didn't necessarily mean they were actually enrolled in that policy.
The reason for this, of course, is that you have to actually pay your first monthly premium in order to have your enrollment "effectuated" (i.e., put into effect).
Yesterday morning on CNN's "State of the Union," host Kasie Hunt talked to Oklahoma GOP Sen. James Lankford about the enhanced ACA tax credits which are currently scheduled to expire exactly 10 days from now.
This gets into the weeds a bit, so I'm breaking it into two separate posts; I'll be publishing the second part tomorrow.
The crux of the CNN appearance was Langford claiming that "Obamacare" (the Affordable Care Act...guys, he's been out of office for nearly 9 years now, let it go willya?) "caused prices to skyrocket in the marketplace" and that the expiration of the enhanced tax credits put into place in 2021 during the COVID pandemic is simply "exposing the real issues" within the ACA.
First of all, let's clear up this "they were only put in place due to the COVID pandemic" talking point which Republicans keep tossing around (the implication being that since the COVID pandemic is over, the subsidy upgrade should end as well).
Get it straight: Eliminating the 400% FPL subsidy cliff and beefing up the tax credit formula is something which Democrats always intended to do when they had the ability to do so.
So, as expected, both the Senate Democrats bill to simply extend the enhanced ACA tax credits for 3 more years and the Senate Republican bill to make everything worse just failed to reach cloture (appropriately enough, they both received the exact same vote counts: 51-48).
Sen. Rand Paul voted against the GOP bill and 4 Republicans voting for the Democrat's bill, including Sen. Josh Hawley, Sen. Lisa Murkowski, Sen. Dan Sullivan & Sen. Susan Collins voting for it. I'm not sure who the missing vote in each was, not that it matters much now.
So, now what?
Well, the House may end up voting on one of their dozen or so bills they've been tossing around, but I wouldn't count on it, and even if one of them passes, it'd be almost certain to fail in the Senate.
With just 4 more days before the initial December 15th deadline to enroll for coverage starting in January, only a weeks' worth of legislative session days before the holiday break, and just 20 days before the enhanced subsidies actually expire on New Year's Eve, it's looking grim.
OK, I know I said I wasn't gonna do a deep dive into any more last-ditch GOP bills ahead of tomorrow's big Senate vote, but this one looks intriguing...but not just for the reasons you might think.
Earlier today, GOP Rep. Jen Kiggans & Democratic Rep. Josh Gottheimer introduced Yet Another short-term enhanced ACA tax credit extension bill...but this one has some very interesting twists.
The mounting support for the legislation, offered by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.), comes as House GOP moderates expressed frustration in a conference meeting Wednesday morning over their leadership’s proposals to address spiking health insurance premiums — without dealing with the expiring tax credits.
