RE-UPPED 1/31/22: It was announced this morning that John James, who lost not one but two statewide U.S. Senate races back to back in 2018 & 2020, is taking a third swing at elected office in 2022. This time he's setting his sights lower, going for Michigan's new open 10th Congressional district, which is still competitive but which definitely has more of a GOP-tilt to it. In light of that, I decided to dust off this post again.
RE-UPPED 4/9/25: It was announced yesterday that John James, who finally made it into elected office as a U.S. Representative in Michigan's 10th Congressional District (only to essentially abandon his district the moment he got re-elected in 2024) is now running for statewide office again, this time for Governor. In light of that, I decided to dust off this post again (again).
A month ago, incumbent Democratic Senator Gary Peters of Michigan and his Republican challenger John James were both interviewed as part of a Detroit Regional Chamber series on several issues, including healthcare policy and the ACA.
This was actually announced a few weeks ago, but I was knee-deep in my Congressional District-level Enrollment Breakout Pie Chart project so I didn't get around to posting about it until now.
Today, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address the troubling amount of improper enrollments impacting Affordable Care Act (ACA) Health Insurance Marketplaces across the country. CMS’ 2025 Marketplace Integrity and Affordability Proposed Rule includes proposals that take critical and necessary steps to protect people from being enrolled in Marketplace coverage without their knowledge or consent, promote stable and affordable health insurance markets, and ensure taxpayer dollars fund financial assistance only for the people the ACA set out to support.
Vulnerable House Republicans warn leaders against cutting Obamacare
The group of centrists also said the party needed to be careful about deep cuts to social safety net programs.
House Republicans in competitive districts warned GOP leaders Thursday: We could lose our seats if you gut Obamacare to pay for a massive border, energy and tax bill.
A group of about a dozen centrist Republicans...worry GOP efforts to pare back the Affordable Care Act could pour fuel on the fire.
...Instead, they argued, Republicans needed to embrace the GOP’s role as the working class party. Leaders would counter that message by slashing programs working Americans rely on, they said. GOP lawmakers in the room included Rep. Brian Fitzpatrick (Pa.), Young Kim (Calif.), David Valadao (Calif.), Andrew Garbarino (N.Y.), Tom Barrett (Mich.) and Don Bacon (Neb.).
On his first day in office, Donald Trump issued dozens of Executive Orders. Some of these are mostly symbolic; some won't have any effect without legislative action; some are blatantly unconstitutional & are already being challenged in court. Many, however, are terrifying and will have horrific consequences for thousands or potentially millions of Americans and non-Americans alike.
Along with issuing his own new ones, Trump has also already rescinded over 60 XOs issued by President Biden. In this post I'm going to focus on three of them which pertain specifically to healthcare policy.
Again, all three of the following have now been RESCINDED BY DONALD TRUMP:
The biggest program on the hit list, however, is Medicaid, which would make up nearly half of the $5 TRILLION in budget cuts Republicans have in mind in order to pay for...massive tax cuts for corporations & the wealthy, of course.
Over at the JAMA Network, KFF Executive VP for health policy Larry Levitt has a piece which lays out the most likely actions (or in one case, lack of action) that the incoming Trump Administration & Republican-controlled Congress will take now that they have a second shot at repealing the Affordable Care Act:
With many tax cuts from the 2017 Tax Cuts and Jobs Act expiring at the end of 2025, a high-profile Congressional debate over extending those tax reductions and enacting new ones is likely. There will be pressure from some in Congress for spending cuts to help pay for those tax cuts. Trump has said that Social Security and Medicare cuts are off the table, and defense reductions are unlikely as well. That means almost half of federal spending would be protected from cuts, leaving Medicaid, which is the next largest source of federal spending, and the ACA as prime targets for spending cuts. The math is inescapable.
Plans in the Health Insurance Marketplace® must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.
Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your deductible
Covered contraceptive methods
FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:
Across these 19 states alone, ACA Medicaid expansion enrollment is up 788,245 people since last March, or 6.7% overall. If you remove Missouri and Oklahoma, it's still up 4.28% since then, and again, this is still as much as 8 months out of date depending on the state. Assuming Illinois is wrong, removing it as well puts expansion enrollment up 5.4% since last March.
Assuming these states are representative, it's safe to assume that Medicaid expansion is up at least 4.3% nationally since March 2022, or around an additional 960,000 people. If you go with the higher end estimate (+5.4%), it would be up over 1.2 million nationally.
That puts the grand total at somewhere between 39.9 - 40.1 million people with ACA-enabled healthcare covered nationally.
While nearly 21.5 million Americans selected Qualified Health Plans (QHPs) via the federal and state ACA exchanges/marketplaces during the official 2024 Open Enrollment Period (along with an additional 1.3 million signing up for a Basic Health Plan (BHP) program in New York & Minnesota, which CMS continues to inexplicably treat as an afterthought in such reports), not all of them actually pay their first monthly premium (for January) for various reasons:
Welp. With last weeks news that House Republicans have decided to once again go to war with the Affordable Care Act if they gain a federal trifecta this November, it's time once again to take a look at just how many of their constituents are at risk of losing their healthcare coverage entirely or, at best, facing massive premium increases (which in most cases would have the same effect by making their coverage cost far more than they could possibly afford).
Alongside this weekends release of the final, official 2024 ACA Open Enrollment Period (OEP) data, The Centers for Medicare & Medicaid Services (CMS) has also pulled together estimates of how many residents of each Congressional District selected ACA exchange plans during the 2024 OEP:
