Charles Gaba's blog

BeWell NM, New Mexico's ACA exchange, has an Open Enrollment Dashboard updated weekly:

As of Dec. 22nd, 2024:

  • Auto-Reenrollments: 40,719
  • Active Enrollments: 18,354
  • New Enrollments: 5,942
  • TOTAL: 65,015

What's more noteworthy is that when compared against the same point last year, New Mexico's 2025 ACA enrollment total is dramatically higher.

Not only is New Mexico's exchange enrollment up a whopping 29% vs. the same point last year, it's actually already 15% higher than the 2024 OEP's final total of 56,472!

Now that the two largest ACA marketplaces (HealthCare.Gov, which hosts 31 states, and Covered California) have joined a half-dozen other states in posting fairly recent 2025 Open Enrollment Period updates, I figured it would be a good time to take a look at where things stand ahead of the big holiday break.

Across 38 states, a total of around 19.5 million people have selected Qualified Health Plans (QHPs) via either the federal or state-based exchanges as of anywhere from 12/05 - 12/18. Collectively, this is roughly 16.6% higher than the same/nearly the same dates a year ago. It's important to remember that Georgia moved from the federal exchange to its own state-based marketplace this year, which is why ~1.2 million enrollees have been subtracted from the 2024 HC.gov total. Note that the HC.gov numbers are rounded off to the nearest 100K, per CMS's press releases both years.

via Covered California:

Covered California Hits Record Enrollment Before its First Key Open Enrollment Deadline on Dec. 31

SACRAMENTO, Calif. — Covered California has surpassed 1.8 million enrollees, reaching its record-high enrollment with over a week until the first open enrollment deadline on Dec. 31.

This open enrollment, 143,686 Californians have signed up for 2025 coverage as of Dec. 14, marking a 3 percent increase over the same period last year.

Another 1,647,162 Californians have renewed their coverage so far, a 4 percent increase over the same period last year.

Combined, that's 1,790,848 Californians who have selected ACA exchange coverage for 2025. Taking the percents above literally that would mean CA had ~1,723,311 QHP selections thru 12/14/23 last year (up 3.9% overall).

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:

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:

via the Centers for Medicare & Medicaid Services (CMS):

Under the Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 64 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from January 1, 2025 – March 31, 2025, since drug companies raised prices for each of these 64 drugs faster than the rate of inflation. Over 853,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and substance use disorder. Since April 1, 2023, people with Medicare have seen savings on over 120 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.

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:

via the Centers for Medicare & Medicaid Services (CMS) just now:

The Centers for Medicare & Medicaid Services (CMS) is committed to a robust Marketplace Open Enrollment process for consumers so they can easily purchase high-quality, affordable health care coverage. CMS reports that a record 16.6 million consumers signed up for plan year 2025 and will receive up to a full year of coverage beginning January 1. Of those consumers, 2 million are new to the Marketplace this year. This represents selections in the 31 states that use HealthCare.gov. Plan selection continues in most State-based Marketplaces, as well. The next national snapshot will be available in early January.

The footnote at the bottom confirms: "These metrics reflect available Federally-facilitated Marketplaces (FFMs) data through December 18, 2024."

via MNsure:

Over 150k Minnesotans have signed up for health insurance since November 1

ST. PAUL, Minn.—Following last year’s incredible enrollment success, MNsure is pleased to report yet another new record for health insurance sign-ups in Minnesota.

Between November 1 and the first deadline (December 18), 151,098 Minnesotans used MNsure.org to sign up for qualified health plans. This represents a 14% increase in private health plan sign-ups compared to the same time last year.

This is excellent news, however, as happens every year with MNsure, it comes with a big caveat.

As I noted a year ago:

This is great, but the 11% higher y/y figure is a bit confusing to me, actually.

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