This is the best OEP ever for the ACA for several reasons:
The expanded/enhanced premium subsidies first introduced in 2021 via the American Rescue Plan, which make premiums more affordable for those who already qualified while expanding eligibility to millions who weren't previously eligible, are continuing through the end of 2025 via the Inflation Reduction Act;
A dozen states are either launching, continuing or expanding their own state-based subsidy programs to make ACA plans even more affordable for their enrollees;
100,000 or more DACA recipients are finally eligible to enroll in ACA exchange plans & receive financial assistance!
9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:
Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:
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.
