Confirmed Exchange QHPs: 12,024,658 as of 6/23/15
Estimated: 12.73M (9.67M via HCgov) as of 6/23/15

Estimated ACA-Enabled Policy Enrollment: 32.7M
(10.3M Paid/Effectuated Exchange QHPs, 8.2M OFF-Exchange QHPs, 180K SHOP, 14.0M Medicaid/CHIP)

Between all the craziness surrounding the King v. Burwell decision and the indirectly-related Obergefell v. Hodges decision and it being my birthday weekend and all, a whole mess of ACA/healthcare stories piled up over the past week...

Hey, everyone, remember this from March?

If I'm reading this correctly, it looks like a whole lot of poor people in non-expansion states were effectively forced into padding their official income in order to qualify for federal tax credits due to their GOP overlords being jackasses. I'm not sure whether that's a problem legally (as opposed to deliberately cutting your official income), but it seems to me that this will only work for so long before it catches up with them recordkeeping-wise?'s a simplified example of how it works:

I originally used this headline after the dust settled on the Year One open enrollment season to discuss my plans for the ACA Signups project going forward. I used it again less than 2 months ago, at the close of Year Two open enrollment (including the #ACATaxTime extension period).

Normally I'd hold off until sometime in February 2016 to pull it out again, but with the King v. Burwell decision out of the way, this seems like a good time to pause and take stock of what lies ahead.

Today happens to be my 45th birthday. Needless to say, like so many others, I'm still winding down from a tumultous week: The Confederate flag being taken down across the land (well, most of it, anyway...) a mere 150 years after the Civil War ended. The Supreme Court ruling that it's a bit unreasonable for 9,800 people to die unnecessarily every year because someone got a little sloppy when typing up their term paper. The Court further ruling that homosexuals have the right to get hit with the marriage penalty at tax time just like the rest of us. An astonishing eulogy for victims of terrorism featuring the President of the United States singing "Amazing Grace". An amazingly bold deeds-not-words action by a young black woman and her white male associate.

The actual numbers haven't changed much over the past week, of course...but The Graph itself has one slight difference. See if you can spot it; it's pretty subtle...

OK, I do have one very quick post this afternoon, and believe it or not, it ties this morning's historic Supreme Court ruling allowing marriage equality for same-sex couples with yesterday's ruling on ACA federal tax credits.

How? Well, the HHS Dept. just posted this on Twitter:

Love is Love. Remember that getting married means a new opportunity to #GetCovered

— (@HHSGov) June 26, 2015

...with this graphic:

At around the same time, HHS Dept. spokesman Aaron Albright posted this:

FYI--Same-sex MARRIED couples and Marketplace coverage.

— Aaron Albright (@AaronKAlbright) June 26, 2015

Same-sex married couples

  1. I'm friggin' exhausted after yesterday.
  2. I'm incredibly backed up with my day job (ie, the website development stuff)
  3. No one's paying attention today anyway...with very good reason!!

Here's the week in review:

A heck of a week, all.

(I know I'm posting the whole thing, but it's only like 6 sentences...please click thru to give Politico the traffic...)

A Texas Republican is taking aim at the Supreme Court after its 6-3 decision upholding Obamacare subsidies with a new bill requiring the justices and their aides to purchase coverage on the law’s exchanges.

Rep. Brian Babin is seeking co-sponsors for the bill, titled the “SCOTUScare Act of 2015” — which refers to a quip from Justice Antonin Scalia’s scathing dissent.

“As the Supreme Court continues to ignore the letter of the law, it’s important that these nine individuals understand the full impact of their decisions on the American people,” the freshman Republican said in a statement. “By eliminating their exemption from Obamacare, they will see firsthand what the American people are forced to live with!”

The King v. Burwell decision this morning is huge. Everything--everything--about the 2016 Open Enrollment Period rested on this morning's decision. And yes, I'm even including the states which have their own exchanges, like California, Kentucky and Connecticut. While those states wouldn't be impacted directly, I guarantee that there would have been some peripheral consequences even for them.

For instance, would a sizable number of self-employed people have moved from, say, Virginia to Maryland due to the 60-90% rate difference they might see between the states? I know it's not easy to just pick up and move your whole family on a whim, but you could be talking about a $500+/month difference for those paying full price...and the difference between having coverage at all or not for those whose premiums had just been cut off. Now, thankfully, we'll never know.