This is gonna be one of the stranger references I've made on this site, but bear with me.
Back in 1996 there was an HBO movie called "The Late Shift" which told the story of the Late Night TV show battle between David Letterman and Jay Leno over who would succeed Johnny Carson as host of The Tonight Show. As stupid as this may sound today, this was actually a Really Big Deal in the '90's...one of those absurd pop culture stories which dominated the headlines and the tabloids for several years.
The movie itself was decent, with some interesting casting including Kathy Bates and Treat Williams, but nothing special. The main problem is that the audience is expected to root and feel sympathy for a couple of dudes who were already rich & famous and who would both continue to be rich & famous no matter how the story played out. The stakes weren't exactly the fate of the world, is what I'm saying.
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:
Ever since the MAGA Murder Bill (officially H.R. 1, the so-called "One Big Beautiful Bill Act") was passed by Republicans in the U.S. Senate & House and signed into law by Donald Trump a few days ago, I've seen a growing conventional wisdom taking hold on social media: People keep claiming that either all, "nearly all" or at least "most of" the budget cuts & other gutting of various programs and departments won't actually kick in until after the November 2026 midterms.
Now, don't get me wrong--most of those making these claims are well-intentioned; they're saying this cynically, to underscore how disingenuous Congressional Republicans are by back-loading the pain until the midterms are safely in their rearview mirrors. And, to be fair, much of the damage won't being until well after next November.
Over at The New Republic, Greg Sargent has taken this thinking one step further, noting that by delaying so much of the ugliness of the new law until 2027 or beyond...
Last week I urged Democrats to demand Congressional Republicans rein in the Trump Regime's out-of-control dictatorial rampage as well as going big on healthcare policy as part of the "government shutdown" battle...but that to the extent that they do make the main focus healthcare policy, at the very least to not settle for simply bumping out the enhanced ACA tax credits by a year or two:
You know I'm a pretty mainstream Democrat. I'm not demanding Medicare for All here. What I am urging on the healthcare front is for three clear demands:
Health Carriers Propose Affordable Care Act Premium Rates for 2026
Anticipated loss of federal enhanced premium tax credits leads to highest individual market rate increases proposed since the start of Maryland’s reinsurance program
BALTIMORE – The Maryland Insurance Administration has received the 2026 proposed premium rates for Affordable Care Act products offered by health and dental carriers in the individual, non-Medigap and small group markets, which impact approximately 502,000 Marylanders.
Maryland Insurance Administration Approves 2026 Affordable Care Act Premium Rates
Despite increases, Maryland remains a national leader in affordable rates; new state subsidy to offset loss of enhanced federal tax credits
BALTIMORE – Maryland Insurance Commissioner Marie Grant today announced the premium rates approved by the Maryland Insurance Administration for individual and small group health insurance plans offered in the state for coverage beginning January 1, 2026.
Rhode Island has around ~42,000 residents enrolled in ACA exchange plans, 88% of whom are currently subsidized. I estimate they also have another ~3,000 unsubsidized off-exchange enrollees.
With the ongoing budget battle approaching the Sept. 30th federal government shut down deadline, U.S. Senator Patty Murray (D-WA) and U.S. Representative Rosa DeLauro (D-CT-03) have formally introduced a bicameral Continuing Resolution bill to fund the government for an extra month to buy more time to negotiate and avoid a shutdown by the Republican-controlled federal government:
Today, Senator Patty Murray (D-WA), Senate Appropriations Committee Vice Chair, and Congresswoman Rosa DeLauro (D-CT-03), House Appropriations Committee Ranking Member, introduced a continuing resolution (CR) to keep the government funded and allow negotiations to continue over full-year bills that ensure Congress, not President Trump or Russ Vought, decide how taxpayer dollars are spent. The CR also addresses the health care crisis Republicans have single-handedly created and protects Congress’ power of the purse, rejecting President Trump’s illegal “pocket rescission.”
Speaker Johnson, Leader Jeffries, Leader Thune, and Leader Schumer,
We urge you to extend the Affordable Care Act’s enhanced premium tax credits. For millions of hard-working Americans, these subsidies are the only reason health insurance is still within reach in a country where the cost of living keeps going up.
If they expire, premiums will rise by thousands of dollars for many families, millions will lose coverage, and people will be forced to make impossible choices between paying for healthcare, rent, or groceries. Hard-working American families, older Americans not yet on Medicare, small business owners, and rural communities—where marketplace coverage is often the only option—will be hit the hardest.
I just finished writing up a deep dive into the Arkansas Insurance Dept's move from laissez faire-style Silver Loading to fully-regulated & maximized Premium Alignment in an attempt to mitigate the massive net premium damage about to be caused if the enhanced ACA premium tax credits expire at the end of 2025.
However, it's not just Arkansas which has finally seen the light and joined about a dozen other states in putting full-bore Premium Alignment (PA) pricing into place to help reduce the financial burden on ACA individual market enrollees in 2026.
Other states which have already done so in the past include Colorado (sort of), Texas, New Mexico, Maryland, Pennsylvania (somewhat), Illinois, Vermont and Wyoming.
