Gideon Lukens
@gidlukens.bsky.social
Senior Fellow and Director of Research, Health Policy @centeronbudget. Former Dep. Director for Economic Policy at OMB. Music lover. Views expressed are my own.
Reposted by Gideon Lukens
As we mark one year since President Trump’s inauguration, it’s important to take stock of the harm the Administration – and congressional Republicans – have inflicted in such a short time. www.cbpp.org/research/fed...
January 20, 2026 at 8:26 PM
As we mark one year since President Trump’s inauguration, it’s important to take stock of the harm the Administration – and congressional Republicans – have inflicted in such a short time. www.cbpp.org/research/fed...
President Trump’s one-page health care plan not only fails to extend enhanced premium tax credits (PTCs), more than doubling out-of-pocket premiums on the ACA marketplace. It also cuts PTCs even further by changing how existing cost-sharing reductions are funded. (1/3) tinyurl.com/37x7wbcz
January 15, 2026 at 9:17 PM
President Trump’s one-page health care plan not only fails to extend enhanced premium tax credits (PTCs), more than doubling out-of-pocket premiums on the ACA marketplace. It also cuts PTCs even further by changing how existing cost-sharing reductions are funded. (1/3) tinyurl.com/37x7wbcz
Reposted by Gideon Lukens
The House passed a measure today to extend the Premium Tax Credit enhancements for three years. The bipartisan vote shows there’s strong support for immediate action to make millions of people’s health care more affordable. All eyes are now on the Senate. x.com/JakeSherman/...
January 8, 2026 at 10:45 PM
The House passed a measure today to extend the Premium Tax Credit enhancements for three years. The bipartisan vote shows there’s strong support for immediate action to make millions of people’s health care more affordable. All eyes are now on the Senate. x.com/JakeSherman/...
Reposted by Gideon Lukens
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...
Marketplace Enrollees In Every Congressional District Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Annual premium increase, 60-year-old couple with income of $85,000 (401% FPL), by congressional district, 119th Congress Note: FPL = federal poverty level. Examples are based on 2026 average...
www.cbpp.org
January 6, 2026 at 6:00 PM
This week, the House is expected to vote on a bill to extend the Premium Tax Credit enhancements. This would reduce 2026 premiums for the average #ACA marketplace enrollee by more than half, improving affordability for millions of people struggling with health costs. www.cbpp.org/research/hea...
Reposted by Gideon Lukens
The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
House Republican Health Care Bill Fails to Address Marketplace Affordability
The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise....
www.cbpp.org
December 16, 2025 at 8:06 PM
The House Republicans’ response to expiring premium tax credit enhancements simply doesn’t respond to expiring PTC enhancements.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Instead, they recycle old Republican policy priorities and do nothing to address the impending marketplace affordability crisis.
Reposted by Gideon Lukens
With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...
House Republicans weigh vote on Obamacare extension
GOP moderates are exploring a last ditch attempt to get a vote to extend expiring subsidies.
www.politico.com
December 12, 2025 at 7:23 PM
With marketplace premium spikes on the verge of hitting 20M+ people Jan. 1, House Speaker Johnson is reportedly considering a bill from Rep.Fitzpatrick with a 2-year extension of PTC enhancements. But the bill raises big concerns. www.politico.com/live-updates...
Reposted by Gideon Lukens
This week is critical for health coverage affordability. CBPP’s @jenniferlsullivan.bsky.social breaks down what’s at stake as Congress votes on extending premium tax credit enhancements & the 3 key dates marketplace enrollees need to know when choosing 2026 coverage: www.youtube.com/watch?v=6QY5...
3 Key Dates to Keep in Mind When Choosing Your Health Coverage Plan for 2026
YouTube video by Center on Budget and Policy Priorities
www.youtube.com
December 11, 2025 at 5:00 PM
This week is critical for health coverage affordability. CBPP’s @jenniferlsullivan.bsky.social breaks down what’s at stake as Congress votes on extending premium tax credit enhancements & the 3 key dates marketplace enrollees need to know when choosing 2026 coverage: www.youtube.com/watch?v=6QY5...
A recent WSJ op-ed reaches the wrong conclusion about a GAO report on #ACA marketplaces. The report details vulnerabilities that call for targeted action – it doesn’t show widespread fraud, and it shouldn’t be used as an excuse to raise ppl’s premiums. tinyurl.com/4rnrpkt2
December 10, 2025 at 3:55 PM
A recent WSJ op-ed reaches the wrong conclusion about a GAO report on #ACA marketplaces. The report details vulnerabilities that call for targeted action – it doesn’t show widespread fraud, and it shouldn’t be used as an excuse to raise ppl’s premiums. tinyurl.com/4rnrpkt2
The Cassidy-Crapo proposal allows PTC enhancements to expire while pushing ppl into skimpier plans with higher deductibles...hard to see how this is a solution to the problem at hand.
Sens Cassidy and Crapo are circulating a health proposal that would do little to address the premium spikes millions of ACA marketplace enrollees will face starting Jan 1, and would further increase many people’s out of pocket costs for health care over time. www.axios.com/2025/12/08/s...
Scoop: Senate GOP chairs circulate health plan as ACA subsidies hang in the balance
Two key Republican chairmen circulated the plan as the GOP struggles to unite around health policies.
www.axios.com
December 8, 2025 at 9:24 PM
The Cassidy-Crapo proposal allows PTC enhancements to expire while pushing ppl into skimpier plans with higher deductibles...hard to see how this is a solution to the problem at hand.
HHS just released data covering the first month of ACA marketplace enrollment for 2026. My colleague @jenniferlsullivan.bsky.social puts the numbers in context:
New HHS data on ACA marketplace enrollment for 2026 so far suggest a similar number of ppl have selected a plan compared to last year even as they see higher premium costs that reflect expiration of PTC enhancements. But don't make too much if it.
Marketplace 2026 Open Enrollment Period Report: National Snapshot | CMS
Marketplace 2026 Open Enrollment Period Report: National Snapshot
www.cms.gov
December 5, 2025 at 10:26 PM
HHS just released data covering the first month of ACA marketplace enrollment for 2026. My colleague @jenniferlsullivan.bsky.social puts the numbers in context:
Reposted by Gideon Lukens
Proposals to address expiring PTC enhancements should be evaluated based on the extent to which they:
1. avoid making more people uninsured;
2. ensure people keep access to affordable, comprehensive coverage; and
3. can take effect quickly.
More here: www.cbpp.org/blog/how-to-...
1. avoid making more people uninsured;
2. ensure people keep access to affordable, comprehensive coverage; and
3. can take effect quickly.
More here: www.cbpp.org/blog/how-to-...
How to Evaluate Proposals to Address Expiring Premium Tax Credit Enhancements
With just weeks to go until the premium tax credit (PTC) enhancements expire — which would increase Affordable Care Act (ACA) marketplace enrollees’ annual premiums by more than $1,000 on average...
www.cbpp.org
December 4, 2025 at 2:39 PM
Proposals to address expiring PTC enhancements should be evaluated based on the extent to which they:
1. avoid making more people uninsured;
2. ensure people keep access to affordable, comprehensive coverage; and
3. can take effect quickly.
More here: www.cbpp.org/blog/how-to-...
1. avoid making more people uninsured;
2. ensure people keep access to affordable, comprehensive coverage; and
3. can take effect quickly.
More here: www.cbpp.org/blog/how-to-...
Reposted by Gideon Lukens
Instead of a clean extension of PTC enhancements (which makes silver plans more affordable), some Republicans have proposed encouraging people to buy down to less generous bronze plans.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
December 2, 2025 at 8:52 PM
Instead of a clean extension of PTC enhancements (which makes silver plans more affordable), some Republicans have proposed encouraging people to buy down to less generous bronze plans.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
Don’t be fooled: While bronze plans often have lower premiums, people face much higher costs when they get care.
ACA marketplace plans w/ $0 premiums help ppl get & stay covered. Recent Republican proposals would require minimum premiums or fail to extend premium tax credit enhancements based on the false claim that ppl who don’t use medical care are “phantom enrollees.” 🧵https://tinyurl.com/4uc68zbf
People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts
Without congressional action, PTC enhancements will expire at the end of 2025. This will cause millions —many of these lowest-income enrollees especially — to become uninsured, or to face impossible c...
tinyurl.com
December 2, 2025 at 5:26 PM
ACA marketplace plans w/ $0 premiums help ppl get & stay covered. Recent Republican proposals would require minimum premiums or fail to extend premium tax credit enhancements based on the false claim that ppl who don’t use medical care are “phantom enrollees.” 🧵https://tinyurl.com/4uc68zbf
Reposted by Gideon Lukens
Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵
November 24, 2025 at 10:18 PM
Reports that the White House is working on a proposal to extend premium tax credit enhancements shows the Administration is acknowledging the urgent need to address premium spikes for millions of marketplace enrollees. But big questions remain.🧵
Reposted by Gideon Lukens
The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.
GAO-25-107480, HEALTH SAVINGS ACCOUNTS: Information on Features and Use,
and Characteristics of Account Holders
files.gao.gov
November 24, 2025 at 8:42 PM
The GAO released a report last week on health savings accounts (HSAs) reaffirming that HSAs do little to help people with low and moderate incomes – who would be hurt the most if Congress lets premium tax credit enhancements expire.
Reposted by Gideon Lukens
Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?
November 24, 2025 at 9:25 PM
Some recent Republican responses to the marketplace premium tax credit issue would shift more people to bronze plans with Health Savings Accounts as an alternative to silver plans with PTC enhancements and cost sharing reductions. So how do these plans stack up in real terms?
Reposted by Gideon Lukens
Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.
November 20, 2025 at 10:16 PM
Here they go again: Republicans in Congress are reviving the ACA repeal debate. After enacting unprecedented cuts to Medicaid, they are looking for ways to eliminate federal premium tax credits that some help about 20M people afford marketplace plans.
We now have congressional district level estimates showing rising out-of-pocket premiums due to expiring premium tax credit enhancements. A 60-yr-old couple making $85k would pay $6.7k to $50k more annually. Explore our interactive map w/ downloadable data: tinyurl.com/5e826bvp
Marketplace Enrollees Across the Country Face Steep Premium Increases Unless Tax Credit Enhancements Are Extended
Annual premium increase, 60-year-old couple with income of $85,000 (401% FPL), by congressional district, 119th Congress Note: FPL = federal poverty level. Examples are based on 2026 average...
tinyurl.com
November 13, 2025 at 10:13 PM
We now have congressional district level estimates showing rising out-of-pocket premiums due to expiring premium tax credit enhancements. A 60-yr-old couple making $85k would pay $6.7k to $50k more annually. Explore our interactive map w/ downloadable data: tinyurl.com/5e826bvp
HSAs are tax shelters masquerading as health policy. They don't help people who are struggling to afford health coverage.
Read more from @nicolerapfogel.bsky.social: tinyurl.com/fh5rabhx
Read more from @nicolerapfogel.bsky.social: tinyurl.com/fh5rabhx
Expanding Health Savings Accounts Would Do Little to Improve Access to Affordable Health Care
Amid the urgent debate over whether Congress will act to prevent cost increases for millions of people in 2026 marketplace plans, some Republicans are promoting expansions of health savings accounts.....
tinyurl.com
November 11, 2025 at 4:04 PM
HSAs are tax shelters masquerading as health policy. They don't help people who are struggling to afford health coverage.
Read more from @nicolerapfogel.bsky.social: tinyurl.com/fh5rabhx
Read more from @nicolerapfogel.bsky.social: tinyurl.com/fh5rabhx
Reposted by Gideon Lukens
#OpenEnrollment for 2026 marketplace plans started Nov 1 in most states. B/c Congressional Rs haven’t extended PTC enhancements, ppl are seeing higher costs as they review their options. If you’re in need of marketplace coverage, here are some key dates to keep in mind during this uncertain time:
November 6, 2025 at 7:00 PM
#OpenEnrollment for 2026 marketplace plans started Nov 1 in most states. B/c Congressional Rs haven’t extended PTC enhancements, ppl are seeing higher costs as they review their options. If you’re in need of marketplace coverage, here are some key dates to keep in mind during this uncertain time:
Reposted by Gideon Lukens
Open enrollment for #ACA marketplace plans has begun, and without congressional action to extend premium tax credit enhancements, millions are facing steep premium increases for 2026.
November 5, 2025 at 2:57 PM
Open enrollment for #ACA marketplace plans has begun, and without congressional action to extend premium tax credit enhancements, millions are facing steep premium increases for 2026.
We now have downloadable graphics like this one for all 50 states plus DC, showing how expiring premium tax credit enhancements are leading to dramatic out-of-pocket premium increases. Find your state here: tinyurl.com/5x89ds7x
November 4, 2025 at 5:17 PM
We now have downloadable graphics like this one for all 50 states plus DC, showing how expiring premium tax credit enhancements are leading to dramatic out-of-pocket premium increases. Find your state here: tinyurl.com/5x89ds7x
How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.
November 4, 2025 at 2:25 PM
How concerned are people about rising health insurance premiums? With premium tax credit enhancements about to expire and ACA marketplace open enrollment underway, search volumes for terms like “health premium increase” are (almost) off the charts.
Wyoming, West Virginia, and Alaska are the states with the largest $$ increases in out-of-pocket premiums for people with moderate incomes who will lose premium tax credits entirely if the enhancements expire.
October 31, 2025 at 7:11 PM
Wyoming, West Virginia, and Alaska are the states with the largest $$ increases in out-of-pocket premiums for people with moderate incomes who will lose premium tax credits entirely if the enhancements expire.
Window shopping for 2026 ACA marketplace plans is open for almost all states, and open enrollment is only days away. Millions of marketplace enrollees are seeing 2026 premiums spike due to expiring premium tax credits. See our paper with state-level estimates: tinyurl.com/zndd97k7
October 29, 2025 at 6:17 PM
Window shopping for 2026 ACA marketplace plans is open for almost all states, and open enrollment is only days away. Millions of marketplace enrollees are seeing 2026 premiums spike due to expiring premium tax credits. See our paper with state-level estimates: tinyurl.com/zndd97k7