With the Senate failing to pass either the Democrats bill to simply extend the enhanced tax credits by 3 more years or the Republicans bill to make everything worse yesterday, all eyes turn to the House, where something like a dozen different bills, some with bipartisan support, some not, have been thrown against the wall to see if anything might stick.
Now, it looks like one of them might actually get a floor vote next week...but only as an amendment to another healthcare bill package being pushed by GOP House leadership, which of course raises all sorts of red flags.
NEWS: Speaker JOHNSON & House GOP leaders are leaning toward giving mods a FLOOR VOTE on a bill extending enhanced ACA subsidies next week
Vote would be on FITZPATRICK bill as an amendment toOP leadership's health package JOHNSON told huddle of mods on the floor earlier he'd support amendment vote & could do it WITHOUT adding abortion funding restrictions.
As public health stakeholders and members of Congress grapple with how to respond to changes in HHS’ vaccine policy, the anti-vaccine organization founded by Secretary Robert F. Kennedy Jr., Children’s Health Defense, is petitioning FDA to remove mRNA COVID-19 vaccines from the market entirely.
FDA has already signaled significant new scrutiny of the COVID-19 vaccines, with biologics center director Vinay Prasad telling staff the vaccines caused at least 10 pediatric deaths. So far, the agency hasn’t provided supporting data for that claim, but confirmed to Bloomberg it is investigating vaccine-associated deaths in both children and adults.
OLYMPIA, Wash. – Today, the Senate failed to pass either of two health care bills they voted on, one of which was to extend the enhanced premium tax credits. Washington Health Benefit Exchange released the following statement:
“We are deeply disappointed Congress failed to extend the enhanced premium tax credits (ePTCs). We know these tax credits have made a tremendous difference to Washingtonians. They have helped to make health insurance more affordable, and without them more people will be forced to go without coverage and increase the uninsured rate. We also know that many of our customers will be forced to make tough decisions to afford the increased costs.
“While this extension was not successful, we are grateful to members of our state Congressional delegation for their leadership in fighting for Washingtonians and highlighting this very important issue and the focus on health care affordability.
ST. PAUL, Minn. — Minnesotans still shopping for health insurance have just five three days left to choose from a variety of coverage plans through MNsure, Minnesota’s official health insurance marketplace.
Monday, December 15, is the deadline to enroll for coverage starting January 1, 2026. For Minnesotans who sign up December 16 – January 15, 2025, coverage will start on February 1 instead.
Premium costs and finding the right plan are top of mind for Minnesotans shopping for health insurance this year. MNsure helps consumers shop with confidence by only selling regulated plans from licensed insurance companies. MNsure.org offers free, anonymous cost estimates and side-by-side plan comparison. Consumers can filter and sort plan options using our online tools or take advantage of free in-person help to make sifting through options easier.
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.
Originally posted 3/07/19. Original headline: "Trump's CMS dusts off the old "Buy Across State Lines" chestnut again"
UPDATE 12/11/25: Kentucky GOP Senator Rand Paul went on FOX Business yesterday to once again push "Buying Across State Lines" (BASL) as a solution to health insurance woes yet again, so it seems like a good time to re-up this post.
(sigh) Here we go again...via CMS:
CMS seeks recommendations that allow Americans to purchase health insurance across state lines
Administration continues efforts to increase consumer choice, promote competition and drive down prices in the health insurance market
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.
House GOP erupts over health care as leaders hunt for a plan
House Republican leaders presented no firm plan Tuesday for advancing health care legislation as anxiety rises in the GOP ranks over the impending expiration of key Obamacare subsidies at the end of the year.
Instead, Speaker Mike Johnson presented attendees of a closed-door conference meeting with list of 10 possible policies that could get votes in the coming weeks or months, according to five Republicans in the room.
Some were more specific, such as an expansion of health savings accounts and an overhaul of pharmaceutical benefit manager oversight. Others were vague, including one bullet point that simply said, “Innovation.” The list did not include an extension of the expiring tax credits.
As I've noted before: While I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).
More important for the moment is the total number of active enrollments, which includes both new enrollees as well as current enrollees who log into their account and actively select a plan for 2026.
In California, those come to 451,576 combined. This also means that only 22% of current enrollees had actively re-enrolled as of 12/06.
As of the same point last year (actually 1 day more; the data from last year is as of 12/07), Covered CA was reporting:
Denver, Colo. – The Dec. 15 deadline to enroll in health insurance for Jan. 1 is fast approaching, and Connect for Health Colorado, the state’s official health insurance marketplace, is encouraging people to shop and start their applications today to avoid a lapse in coverage.
“Dec. 15 is an important deadline; it’s the final day for Coloradans to enroll in health coverage that starts Jan. 1, and our team is ready to help customers stay covered,” said Kevin Patterson, chief executive officer of Connect for Health Colorado. “Staying covered is one of the most important things people can do for their physical and financial well-being. Gaps in coverage can leave Coloradans vulnerable to unexpected medical costs – but we’re here to help. We want to be sure people have the information and assistance they need to choose a plan that works for them.”
Amid tax credit uncertainty, many Washingtonians are still finding their health insurance for 2026 through Washington Healthplanfinder
OLYMPIA, Wash. – During the first month of open enrollment for 2026, more than 268,000 Washingtonians used Washington Healthplanfinder to shop, compare and sign up for health and dental insurance. Even though enhanced premium tax credits for next year may not be extended through Congress, many customers can still find plans with state and federal savings.
Open enrollment is currently underway for 2026, people who sign up by Dec. 15 will have coverage that starts on Jan. 1. Everyone who signs up between Dec. 16 and Jan. 15 will have plans that begin on Feb. 1. At wahealthplanfinder.org, Washingtonians can shop for themselves or find help from a trusted resource in their community. Premium savings may be available to help make monthly costs more affordable.
HARTFORD, Conn. (Dec. 8, 2025) — Access Health CT (AHCT), Connecticut’s official health insurance marketplace, today announced the deadline to enroll in health and dental coverage starting Jan. 1, 2026 is Dec. 15, 2025. Customers who enroll Dec. 16, 2025 through Jan. 15, 2026 will have coverage beginning Feb. 1, 2026.
The Open Enrollment Period for Connecticut residents to shop, compare and enroll in health insurance or renew their coverage began Nov. 1, 2025 and runs through Jan. 15, 2026. Customers may enroll in health and dental coverage.
Hot on the heels of Republican Senators Bill Cassidy of Louisiana & Mike Crapo of Idaho presenting their so-called "Health Care Freedom for Patients Act" which would do almost nothing to actually help ACA enrollees while causing more harm to transgender individuals (of course) and undocumented immigrants (of course), at least two more "The clock is ticking, we have to come up with SOMETHING!" bills have been rolled out today by Congressional Republicans.
Washington, DC -Today, Congressman Van Drew joined a bipartisan coalition of House members calling for a short-term extension of the Affordable Care Act's (ACA) tax credits with targeted modifications of the system. The group also sent a letter to House and Senate leadership asking for a meeting to discuss a clear path forward for health insurance.
Scoop: Senate GOP chairs circulate health plan as clock ticks on ACA subsidies
Two key Senate Republican chairmen are circulating the outline of a health care plan to Republican offices ahead of a crucial week that could decide the fate of enhanced Affordable Care Act subsidies, multiple sources tell Axios.
Why it matters: The plan from Finance Committee chair Mike Crapo (R-Idaho) and health committee chair Bill Cassidy (R-La.) does not extend the tax credits past their expiration at year's end, instead providing funds to enrollees in health savings accounts, according to a summary obtained by Axios.
It's not the only GOP plan that's been floated in recent days as Republicans struggle to unite around health care policies.
TRENTON — In a bulletin issued today, the New Jersey Department of Banking and Insurance issued guidance to insurance carriers on health insurance coverage for childhood immunizations.
The Department advises that, regardless of federal actions relating to the childhood immunization schedule, it expects carriers to provide coverage for childhood immunizations recommended by the New Jersey Department of Health, including for the hepatitis B vaccination series, in accordance with State law and without cost sharing or the imposition of additional barriers.
12/5/25: Update on Provider Network Information in Plan Comparison Tool
We are aware of several provider network inaccuracies in our Plan Comparison Tool. The inaccuracies are related to Anthem plans.
The network issues related to Anthem plans are limited to Northern Light providers. We expect the Anthem network to be corrected by December 16. In the interim, consumers may use Anthem's Provider Lookup Tool (external to CoverME.gov).
Oy...December 16th? That's the day after the initial Open Enrollment Deadline passes. Sheesh.
For nearly a year now, I've been writing about the upcoming expiration of the enhanced ACA premium tax credits (eAPTC) which have been in place for the past five years. They're currently scheduled to expire at the end of December, less than 2 months from today.
Over the past few weeks as the various ACA exchange websites brought their 2026 ACA window shopping live, I've started plugging in different household scenarios to see what actual, real world price hikes look like.
Throughout all of these examples, however, two things have remained consistent:
In yesterday's write-up about CMS posting the first official, state-by-state data breakout for the ongoing 2026 ACA Open Enrollment Period, I noted several possible reasons why so far enrollment is running a solid 11% ahead of the same point a year ago even with widespread knowledge of the enhanced federal tax credits expiring just 25 days from now:
Total 2025 enrollment was 13.4% higher than total 2024 enrollment; assuming a similar rate of net attrition over the course of the year, there should be around 13% more current enrollees who can potentially actively renew/re-enroll for 2026 to begin with. As it happens, re-enrollment is currently up around 14% over the same point a year ago.
There's been a MASSIVE amount of attention given to the ACA, the exchanges, Open Enrollment, etc etc this year due to the panicky headlines about the impending subsidy expiration and of course the 43-day long federal government shutdown which focused primarily on...the ACA, the exchanges, Open Enrollment and the impending subsidy expiration.
The Centers for Medicare & Medicaid Services (CMS) reports that nearly 950,000 consumers who do not currently have health care coverage through plans in the individual market Marketplace have signed up for coverage in 2026, since the start of the Marketplace Open Enrollment Period (OEP) on November 1, 2025. Existing consumers are also returning to the Marketplace to actively renew their coverage, and anyone who does not actively renew will be automatically re-enrolled for 2026. Over 4.8 million existing consumers have already returned to the Marketplace to select a plan for 2026.
Definitions and details on the data in this report are included in the glossary.
As usual, I'll start out with the top line numbers, compared to the same point last year:
On Get Covered Colorado Day, Connect for Health Colorado and state leaders urge customers to compare options and maintain health coverage in 2026.
Denver, Colo.– Today is Get Covered Colorado Day, a day of action designed to encourage as many Coloradans as possible to enroll in 2026 health insurance during Connect for Health Colorado's annual open enrollment period.
“Our message today is simple: we’re here to help every Coloradan get covered,” said Kevin Patterson, chief executive officer of Connect for Health Colorado, the state’s official health insurance marketplace. “Even with premium increases and the possible expiration of federal enhanced Premium Tax Credits, Coloradans are finding plans that fit their needs and their budgets – and they’re not doing it alone. Our experts are ready to guide customers every step of the way. We want Coloradans to know there’s no better time than now to shop, compare options and take advantage of the support we have available.”
There are 43 U.S. House districts where the Republican nominee won by 15 points or less. Of those, one (WA-04) doesn't really count since there were 2 Republicans running in the general election (Washington State has "jungle primaries"). Four others were won by Donald Trump by between 16 - 20 points (AZ-08, CO-04, TX-15 & WI-08).
That leaves 38 GOP-held House seats where the Republican won by 15 pts or less and where either Kamala Harris won, or Donald Trump also won by 15 points or less. The table below breaks these out with both margins, while also listing my estimate of how many residents of each district are enrolled in ACA coverage.
To: Plymouth Union Public Advocacy From: Tony Fabrizio & Bob Ward
Date: July 14, 2025
Re: Expiration of Premium Tax Credits Survey – Targeted Congressional Districts
Our survey of voters in the most competitive Congressional Districts shows Republicans have an opportunity to overcome a current generic ballot deficit and take the lead by extending the healthcare premium tax credits for those who purchase health insurance for themselves. Without Congressional action, the tax credit expires this year.
For 12 years now, one of the traditions of ACA Signups has been The Graph: A line graph tracking enrollment in ACA policies over the course of each Open Enrollment Period.
The original Graph from 2013-2014 looked quite different from more recent years, partly because I was attempting to track Medicaid/CHIP enrollment and other coverage categories at the same time, and partly because, frankly, I didn't really know what I was doing at the time.
Over the next few years I modified & improved both my methodology as well as the format, culminating in last year's 2025 Open Enrollment Period Graph, which featured the highest enrollment figures in the ACA's history: ~24.3 million Qualified Health Plan (QHP) enrollees, plus another ~1.8 million Basic Health Plan (BHP) enrollees in Minnesota, New York & Oregon specifically, for a grand total of just a hair over 26 million people.
For the 2026 Open Enrollment Period, however, actual hard enrollment data has been, shall we say, difficult to come by so far.
I don't know if this is new or not, but it turns out that Covered California--the largest state-based ACA exchange in the country--has an Open Enrollment Dashboard after all!
This means that in addition to two small states regularly reporting Open Enrollment data (Maine and New Mexico), the largest one is as well!
Here's what Covered CA is reporting as of November 29th:
New enrollments: 45,023
Active renewals: 365,879
Passive/Autorenewals: 1,412,526
Total: 1,823,428
As I've noted in both my Maine and New Mexico updates, while I include the passive/auto-renewal number for completeness sake, that number won't really be relevant until after the deadline for January 1st coverage passes (which is December 15th in most states, although not until 12/23 in MA & 12/31 in MD, NV, NJ, NM & RI).4,
via MNsure, Minnesota's ACA exchange (email only for now):
Minnesota residents affected by the end of Strategic Limited Partners coverage can enroll in new health insurance through MNsure
ST. PAUL, Minn.—MNsure is opening a limited special enrollment period (SEP) for Minnesota residents who purchased insurance through Strategic Limited Partners offsite of the MNsure website. The SEP follows enforcement action by the Minnesota Department of Commerce.
Commerce found that Strategic Limited Partners, an unlicensed company, sold unauthorized and deceptive health coverage to Minnesotans through misleading ads. Under a consent order, Strategic Limited Partners must cease operations by December 31, 2025, notify customers of its exit, repay outstanding claims, and pay a civil penalty.
To protect affected consumers, MNsure is offering this limited SEP:
While it appears that Congress will allow enhanced federal Premium Tax Credits to expire, New Mexico’s Health Care Affordability Fund (HCAF) will cover the loss of the enhanced premium tax credits for households with income under 400% of the Federal Poverty Level (or $128,600 for a family of four), providing up to $68 million in premium relief for working families who enroll in coverage through BeWell in 2026. Federal and state premium assistance will continue to reduce the impact of the rate increases.
The Maine Department of Health and Human Services (DHHS) Office of the Health Insurance Marketplace (OHIM) will release biweekly updates on plan selections through CoverME.gov, Maine’s Health Insurance Marketplace.
Plan selections provide a snapshot of activity by new and returning consumers who have selected a plan for 2026. “Plan selections” become “enrollments” once consumers have paid their first monthly premium to begin coverage. These numbers are subject to change as consumers may modify or cancel plans after their initial selection.
The deadline to select a plan for coverage beginning January 1, 2026 is December 15, 2025. Consumers who select a plan between December 16, 2025 and January 15, 2026 will have coverage beginning February 1, 2026.
New Mexico Open Enrollment 2026 - Enrollment Summary
Last Refreshed On: December 2, 2025
Officially, they're reporting 75,926 Qualified Health Plan (QHP) enrollments already, which is actually 8% higher than the 70,373 which they ended with during the 2025 Open Enrollment Period (OEP) last January.
HOWEVER...and this is a major caveat...that 75,926 includes all current enrollees being auto-renewed for 2026, which doesn't really count for my purposes. Most state exchanges used to hold off on lumping in the auto-renewals until after the initial December deadline, only reporting current enrollees who actively re-enroll along with new enrollees.
Earlier this afternoon I joined cancer survivor and healthcare reform advocate Laura Packard on her CareTalk podcast to discuss the upcoming expiration of the enhanced ACA tax credits and the Trump Regime's confusing, will-they-or-won't-they non-proposal to maybe, possibly extend them...with a bunch of major caveats attached. Tune in!
For nearly a year now I've been shouting from the rooftops about the eye-popping net premium hikes which millions of ACA enrollees are going to see starting one month from today, assuming the enhanced Advanced Premium Tax Credits (eAPTC) which have been in place for the past five years are allowed to expire on New Year's Eve.
I've put together 51 bar graphs showing examples of what these net premium increases will look like for various households at different income levels in every state. Since there's so many variables from state to state including different Rating Areas, different levels of carrier participation, different provider networks and different benchmark Silver plans from county to county (and even from zip code to zip code), I decided to use the capital city of each state as my rule of thumb.
For the households, I went with four case studies: A single 50-yr old adult w/no dependents; a 30-yr old single parent with one child; a "nuclear family" (40-yr old couple with two kids age 15 & 12); and a pre-retiree couple (64 yrs old, just shy of Medicare eligibility age).
