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Non-Profit Hospitals Face Near-Term Challenges

The end of Affordable Care Act enhanced health insurance premiums will pose a financial challenge for many of the nation’s non-profit hospitals. The challenge to hospitals will be greatest in states that did not take advantage of Affordable Care Act Medicaid expansion and those with especially large concentrations of rural hospitals that also lack a robust health care safety net. On safer ground will be hospitals in states that do have strong health care safety nets or that have taken recent steps to attempt to fill the void left by [...]

February 9, 2026|Categories: Affordable Care Act, hospitals, Medicaid|Tags: Affordable Care Act enhanced insurance premium subsidies, health care safety net, Medicaid expansion, Rural hospitals|

Federal Health Policy Update for February 5

The following is the latest health policy news from the federal government for January 30 through February 5. Some of the language used below is taken directly from government documents. Congress On Tuesday Congress passed, and the president immediately signed, a package of appropriations bills that, among other government operations, funded the Department of Health and Human Services for the rest of federal FY 2026. Major provisions include: The extension of telehealth flexibilities through the end of 2027. The elimination of $8 billion cuts in Medicaid disproportionate share (Medicaid DSH) [...]

February 5, 2026|Categories: Accountable Care Organization, ACO, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|Tags: Assisted Outpatient Treatment grant program, Certified Community Behavioral Health Clinics, Community Mental Health Services Block Grant, Geographic Practice Cost Index, GME payments, graduate medical education payment, HRSA eNews, maternity care health professional target areas, measles, Medicaid disproportionate share, Medicaid DSH, Medicaid state directed payments, Medicaid state plan amendment, Medicare accountable care organizations, Medicare ACOs, Medicare Acute Hospital Care at Home program, Medicare Advantage, Medicare ambulatory surgical center payment system, Medicare dependent hospital program, Medicare end-stage renal payment system, Medicare low-volume hospital adjustment, Medicare sequestration, MLN Connects, Office of the Assistant Secretary for Technology Policy request for information, Rural Health Clinics, Safety Through Recovery Engagement and Evidence-based Treatment and Supports Initiative, STREETS initiative, Substance Use Prevention Treatment and Recovery Services Block Grant, telehealth|

Demise of Enhanced Tax Credits Drives Lower ACA Plan Enrollment

The end of enhanced tax credits for Affordable Care Act health plans has led to a five percent decrease in the number of people who enrolled in ACA plans during the open enrollment period that ended on January 15. According to federal data, about 23 million Americans signed up for such plans this year, down 1.1 million from last year – a significant decline, although not as great as predictions that enrollment could fall as much as 30 percent. Because of the loss of the enhanced premiums tax credits, insurance [...]

February 2, 2026|Categories: Affordable Care Act, Congress|Tags: Affordable Care Act advanced tax premium credits, Affordable Care Act enhanced tax premium credits, Affordable Care Act health plans|

Federal Health Policy Update for January 29

The following is the latest health policy news from the federal government for January 23-29. Some of the language used below is taken directly from government documents. Congress The Senate today failed to advance a package of the remaining six FY 2026 appropriations bills, including funding for the Department of Health and Human Services. Democratic senators continue negotiating with the White House on how to proceed with Department of Homeland Security (DHS) funding, including the possibility of separating the DHS bill from the broader appropriations package and making targeted amendments to [...]

January 29, 2026|Categories: Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy, MedPAC, Telehealth|Tags: 2026 Affordable Care Act exchange enrollments, 2026 federal poverty level standards, American-made supply chain for personal protective equipment and essential medicines, CMS Open Payments data, CMS PEPPER, CMS Program for Evaluating Payment Patterns Electronic Report, CMS technical experts panels, CY 2027 Medicare Advantage and Part D Advance Notice, DMEPOS, DMEPOS master list, durable medical equipment prosthetics orthotics and supplies, FY 2026 HHS appropriations bill, independent dispute resolution, Innovation in Behavioral Health Model, MACPAC, MACPAC and Medicare Advantage, MACPAC and Medicare prescription drug benefit plans, Medicaid and CHIP Payment and Access Commission, Medicaid community engagement requirement, Medicaid eligibility criteria, Medicaid state plan amendments, Medicare and Medicare prescription drug benefit plans, Medicare Diabetes Prevention Program, Medicare Drug Price Negotiation Program, Medicare Payment Advisory Commission, MedPAC, MedPAC and Medicare Advantage, MLN Connects, No Surprises Act, no surprises act independent dispute resolution, Organ Procurement Organization, skilled nursing facility annual payment update calculation, Special Focus Facility program, state prescription drug affordability boards, Substance Abuse and Mental Health Services Administration, Young Breast Cancer Survivors Metastatic Breast Cancer Patients and Their Families Program|

Providers Continue to Dominate Fee Dispute Resolution

Health care providers won the vast majority of the fee disputes adjudicated through the No Surprises Act’s Independent Dispute Resolution process during the first half of 2025. The volume of those disputes submitted to arbitration rose nearly 40 percent over the first half of 2024, to 1.2 million cases, and the victory rate of providers also rose, from 85 percent to 88 percent.Leading the way for providers were private equity-backed parties, with three such companies accounting for 44 percent of the disputes submitted during the first half of 2025 and [...]

January 29, 2026|Categories: Uncategorized|Tags: Independent Dispute Resolution process, No Surprises Act|

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