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 watched the full 3 hours of the hearing and liveposted the entire thing on Bluesky. Needless to say, there are some typos and grammatical errors, and much of what I posted is paraphrasing, but it's as accurate as I could make it in the moment:
Here comes Round 2 of RFK Jr's confirmation hearings.
Sen. Bill Cassidy (R) is the chair. Sen. Bernie Sanders (I) is the ranking member.
Nomination of Robert F. Kennedy, Jr. to serve as Secretary of Health and Human Services | The U.S. Senate Committee on Health, Education, Labor & Pensions
The U.S. Senate Committee on Health, Education, Labor & Pensions
UPDATE 4/18/25: More recent Medicaid/CHIP enrollment data has become available since I first published the spreadsheet, as well as more recent total population estimates. I'm in the process of updating each but the existing spreadsheet data should still be pretty accurate. I'll post again once the spreadsheet itself has been updated.
However, for no particular reason, I included the methodology for Medicaid & CHIP data in with the ACA enrollment post, since it ACA Expansion Medicaid overlaps with that.
Covered California Reaches Record-Breaking 1.9M Enrollees Before Open Enrollment’s Jan. 31 Deadline
SACRAMENTO, Calif. — Covered California has surpassed 1.9 million enrollees, bolstering its record-high enrollment before open enrollment’s Jan. 31 deadline for California’s remaining uninsured.
This open enrollment, 299,060 Californians have signed up for 2025 coverage as of Jan. 26, a 13 percent increase over the same period last year.
Another 1,638,954 Californians have renewed their health insurance plans, a 10 percent jump over the same date last year, with more than 100,000 total enrollees in 2025 as compared to the record enrollment in 2024.
Combined, that's 1,938,014 QHP selections thru 1/26, or 8.6% higher than last year's final OEP tally of 1,784,653 QHPs.
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:
The first official press release from the Centers for Medicare & Medicaid Services (CMS) under the Trump 2.0 Administration is out, and not only is it pretty innocuously worded...it's actually complimentary of the Inflation Reduction Act, which is noteworthy given that the IRA was passed & signed into law exclusively by Democrats & President Biden:
CMS Statement on Lowering the Cost of Prescription Drugs
Lowering the cost of prescription drugs for Americans is a top priority of President Trump and his Administration. In accordance with the statutory requirements of the Inflation Reduction Act, the Centers for Medicare and Medicaid Services (CMS) released the list of 15 drugs selected for the second cycle of the Medicare Drug Price Negotiation Program on January 17, 2025.
Early Monday evening I received a copy of a memo that will impact thousands of institutions supported by funding from the federal government.
A copy of the memo from the Office of Management and Budget (OMB) was provided to The Handbasket at approximately 5pm ET by a source whose anonymity is being protected for fear of professional retribution. The memo was sent to the heads of executive departments and agencies with the subject, “Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs.” I shared the news on Bluesky at 6:04pm ET, and my reporting was confirmed by the Washington Post a few hours later.
It is a truly unhinged document that sounds like it was written by the world’s most petty 4Chan poster—but then again, that’s who’s currently running our federal government. Here’s the first paragraph to get a feel for it (emphasis mine):
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:
Below I'm posting a similar breakout of total ACA Medicaid Expansion enrollment from January 2014 - June 2024, via the Centers for Medicare & Medicaid Services quarterly Medicaid Budget & Expenditure System reports (warning: That link could be broken or blank by the time you read this under the Trump Administration).
Unfortunately, the MBES reports currently only run through June of last year, so the last half of the year is missing.
No further analysis or comment here; I just think this is a pretty cool graphic...and keep in mind that most of the people represented here would have been utterly screwed from early 2020 - early 2023 without the Affordable Care Act being in place when the pandemic hit.
Click the image for a higher-resolution version. I'm not bothering to include the state labels since some would be too difficult to make out, but it starts with Alaska at the bottom and works its way up to West Virginia at the top (remember, neither Alabama nor Wisconsin or Wyoming have expanded Medicaid under the ACA). It also includes Guam, Puerto Rico and the U.S. Virgin Islands.
