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Gideon Lukens

@gidlukens

Senior Fellow and Director of Research, Health Policy @centeronbudget. Former Dep. Director for Economic Policy at OMB. Music lover. Views expressed are my own.

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Latest posts by Gideon Lukens @gidlukens

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How does recent growth compare to recent years?

Economy added just 0.16 million jobs over 12 months to Feb 2026.

Job growth stopped.

06.03.2026 13:34 πŸ‘ 57 πŸ” 34 πŸ’¬ 4 πŸ“Œ 4
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Medicaid Plays an Important Role in Providing Health Coverage to Key Populations Medicaid ensures that people of all ages have access to the health care they need, covering 2 in 5 children, 1 in 6 non-elderly adults, and 1 in 7 seniors nationwide.

#Medicaid is a critical source of coverage for many populations, incl. kids, adults, & ppl w/ disabilities. @CenterOnBudget’s new fact sheet details the important role the program plays in keeping ppl healthy: www.cbpp.org/research/hea...

25.02.2026 16:03 πŸ‘ 1 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
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Health Savings Accounts Can Be a Bad Deal for Low-Income Marketplace Enrollees In the wake of their actions that have worsened health care affordability, President Trump and Republicans in Congress have pushed to expand health savings accounts (HSAs). But this doubles down on an...

Marketplace enrollees’ premiums have skyrocketed following the recent expiration of PTC enhancements. Some have suggested health savings accounts and less generous plans as a more affordable alternative to comprehensive coverage. Here’s why that line of reasoning is flawed: 🧡

23.02.2026 16:37 πŸ‘ 9 πŸ” 9 πŸ’¬ 1 πŸ“Œ 1
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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...

20.01.2026 20:26 πŸ‘ 24 πŸ” 20 πŸ’¬ 1 πŸ“Œ 1

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)

15.01.2026 21:18 πŸ‘ 4 πŸ” 3 πŸ’¬ 1 πŸ“Œ 1
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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...

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

15.01.2026 21:17 πŸ‘ 4 πŸ” 3 πŸ’¬ 1 πŸ“Œ 0
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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

15.01.2026 21:17 πŸ‘ 10 πŸ” 5 πŸ’¬ 1 πŸ“Œ 1
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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/...

08.01.2026 22:45 πŸ‘ 17 πŸ” 11 πŸ’¬ 1 πŸ“Œ 1
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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...

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...

06.01.2026 18:00 πŸ‘ 30 πŸ” 23 πŸ’¬ 4 πŸ“Œ 3
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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....

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.

16.12.2025 20:06 πŸ‘ 12 πŸ” 6 πŸ’¬ 1 πŸ“Œ 2
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House Republicans weigh vote on Obamacare extension GOP moderates are exploring a last ditch attempt to get a vote to extend expiring subsidies.

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...

12.12.2025 19:23 πŸ‘ 8 πŸ” 4 πŸ’¬ 1 πŸ“Œ 0
3 Key Dates to Keep in Mind When Choosing Your Health Coverage Plan for 2026
3 Key Dates to Keep in Mind When Choosing Your Health Coverage Plan for 2026 YouTube video by Center on Budget and Policy Priorities

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...

11.12.2025 17:00 πŸ‘ 7 πŸ” 8 πŸ’¬ 0 πŸ“Œ 0

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.

10.12.2025 15:57 πŸ‘ 1 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0
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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.

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

10.12.2025 15:56 πŸ‘ 1 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

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.

10.12.2025 15:56 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

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.

10.12.2025 15:56 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

The specific vulnerabilities that GAO discusses are consistent with what we learned last year. As GAO states, their findings are β€œillustrative” and β€œcannot be generalized to the overall enrollment population.”

10.12.2025 15:56 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

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

10.12.2025 15:55 πŸ‘ 4 πŸ” 7 πŸ’¬ 1 πŸ“Œ 0

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.

08.12.2025 21:23 πŸ‘ 3 πŸ” 3 πŸ’¬ 1 πŸ“Œ 0

HHS just released data covering the first month of ACA marketplace enrollment for 2026. My colleague @jenniferlsullivan.bsky.social puts the numbers in context:

05.12.2025 22:26 πŸ‘ 2 πŸ” 2 πŸ’¬ 0 πŸ“Œ 0
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How to Evaluate Proposals to Address Expiring Premium Tax Credit Enhancements With just weeks to go until the premium tax credit (PTC) enhancements expire β€” which would increase Affordable Care Act (ACA) marketplace enrollees’ annual premiums by more than $1,000 on average...

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-...

04.12.2025 14:39 πŸ‘ 8 πŸ” 6 πŸ’¬ 0 πŸ“Œ 1
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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.

02.12.2025 20:52 πŸ‘ 5 πŸ” 5 πŸ’¬ 1 πŸ“Œ 2

#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.

02.12.2025 17:28 πŸ‘ 1 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0
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...

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

02.12.2025 17:28 πŸ‘ 1 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
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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.

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

02.12.2025 17:28 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
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How would eliminating $0 Marketplace premiums affect insurance coverage? | Brookings

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

02.12.2025 17:27 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

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.

02.12.2025 17:27 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

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.

02.12.2025 17:27 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0
Covered California’s Data Tells A Fuller Story About ACA Marketplace Utilization | Health Affairs Forefront Based on data from Covered California, we reject the characterization of ACA marketplace enrollees with no claims history as β€œphantom enrollees.”

The prevalence of enrollees without claims increased in recent years, but that’s because enhancements to premium tax credits pulled in people who use less medical care – because they’re enrolled for shorter periods & because they’re younger and healthier. tinyurl.com/5t2kd9y4

02.12.2025 17:27 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0

The existence of ppl w/out claims is a normal feature of all health & other insurance markets– not evidence of fraud, & certainly not evidence that enrollees are β€œphantoms.” Ppl can’t always predict when they’ll need to use their insurance, but it’s meant to be there when they do.

02.12.2025 17:26 πŸ‘ 0 πŸ” 0 πŸ’¬ 1 πŸ“Œ 0