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...
Meanwhile, the plan would send people cash. It’s entirely unclear how much help people would get, or how this would work, much less why it’s better than acting immediately to directly cover people’s premiums through PTC enhancements. (3/3)
January 15, 2026 at 9:18 PM
Meanwhile, the plan would send people cash. It’s entirely unclear how much help people would get, or how this would work, much less why it’s better than acting immediately to directly cover people’s premiums through PTC enhancements. (3/3)
Along with dramatically raising people’s health care costs, allowing PTC enhancements to expire would cause 4M people to become uninsured. And changing the way cost sharing reductions are funded would cause hundreds of thousands more to become uninsured. (2/3) tinyurl.com/ydsxsz62
A Record of Historic Harm in the First Year of Trump’s Second Term
The breadth of actions harming low- and moderate-income people over the last year is staggering, with huge cuts to health coverage, food assistance, and other basic needs programs, paired with hikes i...
tinyurl.com
January 15, 2026 at 9:17 PM
Along with dramatically raising people’s health care costs, allowing PTC enhancements to expire would cause 4M people to become uninsured. And changing the way cost sharing reductions are funded would cause hundreds of thousands more to become uninsured. (2/3) tinyurl.com/ydsxsz62
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...
The way to combat fraud is by addressing it through targeted and direct solutions that protect people from improper conduct – not by allowing people’s premium costs to spike and taking away their health coverage.
December 10, 2025 at 3:57 PM
The way to combat fraud is by addressing it through targeted and direct solutions that protect people from improper conduct – not by allowing people’s premium costs to spike and taking away their health coverage.
What should NOT be done is to allow premium tax credit enhancements to expire, which would raise costs for 20+ million ppl & cause nearly 4 million to become uninsured. Nor should enrollees be forced to make minimum premium payments as some have proposed.
tinyurl.com/zndd97k7
tinyurl.com/zndd97k7
Health Insurance Premium Spikes Imminent as Tax Credit Enhancements Set to Expire
If Congress waits until the end of the year to extend the enhancements, 1.5 million more people will be uninsured in 2026 compared to an earlier extension.
tinyurl.com
December 10, 2025 at 3:56 PM
What should NOT be done is to allow premium tax credit enhancements to expire, which would raise costs for 20+ million ppl & cause nearly 4 million to become uninsured. Nor should enrollees be forced to make minimum premium payments as some have proposed.
tinyurl.com/zndd97k7
tinyurl.com/zndd97k7
In 2024, CMS took actions to curtail fraudulent broker activity. More can be done through common-sense legislation to crack down on bad-actor brokers and address vulnerabilities.
December 10, 2025 at 3:56 PM
In 2024, CMS took actions to curtail fraudulent broker activity. More can be done through common-sense legislation to crack down on bad-actor brokers and address vulnerabilities.
Fraud calls for targeted actions. It does not call for policies that would put millions of people’s health at risk by raising premiums for nearly all #ACA marketplace enrollees and taking away coverage.
December 10, 2025 at 3:56 PM
Fraud calls for targeted actions. It does not call for policies that would put millions of people’s health at risk by raising premiums for nearly all #ACA marketplace enrollees and taking away coverage.
The specific vulnerabilities that GAO discusses are consistent with what we learned last year. As GAO states, their findings are “illustrative” and “cannot be generalized to the overall enrollment population.”
December 10, 2025 at 3:56 PM
The specific vulnerabilities that GAO discusses are consistent with what we learned last year. As GAO states, their findings are “illustrative” and “cannot be generalized to the overall enrollment population.”
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 enrollees are real people – not phantoms. Policymakers should not let false arguments get in the way of extending the premium tax credit enhancements to prevent people’s premiums from spiking and allow them to stay covered.
December 2, 2025 at 5:28 PM
#ACA marketplace enrollees are real people – not phantoms. Policymakers should not let false arguments get in the way of extending the premium tax credit enhancements to prevent people’s premiums from spiking and allow them to stay covered.
While insurance broker fraud is real, the federal government has already taken steps to curtail bad actors. Targeted solutions protect people from improper conduct without raising their premiums or causing them to lose coverage. tinyurl.com/2zzfx5yv
CMS Update on Actions to Prevent Unauthorized Agent and Broker Marketplace Activity | CMS
The Centers for Medicare & Medicaid Services (CMS) continues to exercise its full statutory and regulatory authority to protect the integrity of the Federally-facilitated Marketplaces (FFMs), which in...
tinyurl.com
December 2, 2025 at 5:28 PM
While insurance broker fraud is real, the federal government has already taken steps to curtail bad actors. Targeted solutions protect people from improper conduct without raising their premiums or causing them to lose coverage. tinyurl.com/2zzfx5yv
And allowing premium tax credit enhancements to expire would raise premium costs for over 20 million people and cause 3.8 million to become uninsured. tinyurl.com/zndd97k7
Health Insurance Premium Spikes Imminent as Tax Credit Enhancements Set to Expire
If Congress waits until the end of the year to extend the enhancements, 1.5 million more people will be uninsured in 2026 compared to an earlier extension.
tinyurl.com
December 2, 2025 at 5:28 PM
And allowing premium tax credit enhancements to expire would raise premium costs for over 20 million people and cause 3.8 million to become uninsured. tinyurl.com/zndd97k7
Disallowing marketplace plans from offering $0 premium options or requiring people to make minimum premium payments could cause roughly a million people to lose marketplace coverage due to additional red tape, researchers estimate. tinyurl.com/2wkzmexn
How would eliminating $0 Marketplace premiums affect insurance coverage? | Brookings
tinyurl.com
December 2, 2025 at 5:27 PM
Disallowing marketplace plans from offering $0 premium options or requiring people to make minimum premium payments could cause roughly a million people to lose marketplace coverage due to additional red tape, researchers estimate. tinyurl.com/2wkzmexn
And the ACA includes a backstop: if insurers take in too much in premiums compared to what they pay out for health care services, the money has to go back to consumers.
December 2, 2025 at 5:27 PM
And the ACA includes a backstop: if insurers take in too much in premiums compared to what they pay out for health care services, the money has to go back to consumers.
More enrollees without claims also doesn’t mean more money for insurance companies: if enrollment goes up but there are no additional claims, the cost per enrollee goes down. That means the premium per enrollee – and the federal cost per enrollee – also goes down.
December 2, 2025 at 5:27 PM
More enrollees without claims also doesn’t mean more money for insurance companies: if enrollment goes up but there are no additional claims, the cost per enrollee goes down. That means the premium per enrollee – and the federal cost per enrollee – also goes down.