Affordable Care Act

Federal Health Policy Update for July 23

Don’t Miss: Congress advances health care bills CMS proposes provider tax rule Courts act on ACA changes, 340B The following is the latest health policy news from the federal government for July 17-23. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee held a markup for 29 bills, advancing the following health care transparency measures with bipartisan support: H.R. 9390, Prices on the Wall Act of 2026 H.R. 9393, Lower Costs, More Transparency Act of 2026, part of a package that also includes: H.R. 3514, Improving Seniors’ Timely Access [...]

joe2026-07-23T16:29:15-04:00July 23, 2026|340b, Affordable Care Act, MACPAC, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

Court Pauses Parts of ACA Rule

A federal court in Maryland has issued a temporary stay in the implementation of eight provisions in CMS’s Affordable Care Act marketplace rule – provisions that were to take effect on July 20. In a challenge to the legality of portions of the regulation in the case of City of Columbus v. Kennedy, the court concluded that the plaintiffs were likely to succeed in their challenge to some provisions in question even before further proceedings and therefore vacated: the expansion of eligibility for catastrophic plans through an income-based hardship exemption; expansion of annual maximum out-of-pocket limits and revised cost-sharing requirements [...]

joe2026-07-21T17:09:25-04:00July 22, 2026|Affordable Care Act|

Where is ACA Enrollment Falling the Most?

While the decline in Affordable Care Act enrollment in 2026 is getting a great deal of attention – enrollment is down 13 percent or three million in 2026 – are there some places where enrollment is falling more than in others? Yes. In Oklahoma and Ohio, ACA plan enrollment has fallen by nearly a third. Enrollment also is down significantly in Arizona, Indiana, Louisiana, Michigan, Minnesota, Mississippi, and South Carolina. The enrollment declines are generally attributed to the loss of enhanced premium tax credits that were eliminated in H.R. 1, last year’s federal budget reconciliation bill. Learn more about falling [...]

joe2026-07-08T11:18:11-04:00July 9, 2026|Affordable Care Act|

Federal Health Policy Update for July 2

Don’t Miss: CMS proposes CY 2027 Medicare outpatient rates, reviving 340B cuts, expanding site-neutral payments CMS calls for modest Medicare home health pay hike, more ways to oust providers Court halts borrowing limit that jeopardized supply of qualified health professionals The following is the latest health policy news from the federal government for June 25-July 2. Some of the language used below is taken directly from government documents. Proposed CY 2027 Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Rule CMS has published its proposed Medicare FY 2027 outpatient and ambulatory surgical center prospective payment system rule. The proposed [...]

joe2026-07-02T16:55:39-04:00July 2, 2026|340b, Accountable Care Organization, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

ACA Marketplace Enrollment Declines

Nearly three million fewer people have enrolled in health insurance plans through the Affordable Care Act Marketplace than last year, according to new federal data. Enrollment in ACA plans so far this year stands at 19.2 million, down nearly three million, or 13 percent, from last year’s high of 22.1. This is the first time overall marketplace enrollment has declined since 2018. While many observers credit this decline to the elimination of enhanced subsidies that helped some people pay their insurance premiums, the administration attributes much of the decline to its success in addressing fraudulent applicants and applications. The reduced [...]

joe2026-06-30T17:05:56-04:00July 1, 2026|Affordable Care Act|

Federal Health Policy Update for June 18

Don’t Miss: 340B Rebate Model pilot program – next steps Stricter rules on CMS’s reviews of new and existing section 1115 Medicaid demonstration programs Changes in health care institution accrediting practices HHS posts mental and behavioral health grant opportunities The following is the latest health policy news from the federal government for June 12-18. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress will return to session on June 22. The House Energy and Commerce Committee’s Oversight and Investigations Subcommittee will hold a hearing titled “State Medicaid Program Integrity: Examining Fraud Risks [...]

joe2026-06-18T16:07:51-04:00June 18, 2026|340b, Affordable Care Act, Alternative payment models, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Marketplace Enrollment Declines

With the elimination of enhanced premium tax credits, enrollment in Affordable Care Act health insurance exchange plans is falling. Last year saw 24 million people enroll in ACA marketplace plans – an all-time high. 2026 enrollment, though, is down 1.2 million, or five percent – the largest year-to-year decline since the exchanges started offering health insurance in 2014. Overall, enrollment has fallen in 41 states, with those declines ranging from one to 22 percent. In addition, 14 percent of those who signed up for plans in 2026, or who were automatically reenrolled because of past enrollment, did not pay their [...]

joe2026-06-10T11:43:01-04:00June 11, 2026|Affordable Care Act|

Federal Health Policy Update for May 28

The following is the latest health policy news from the federal government for May 22-28. Some of the language used below is taken directly from government documents. Congress When Congress returns from the Memorial Day recess next week, lawmakers will have to address the Republican-led reconciliation bill to fund ICE and CBP. After, they plan to start working on a third party-line bill focusing on affordability—including health care—which leadership aims to pass by the end of July. Next week, the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies is scheduled to mark up its Fiscal [...]

sysadmin2026-05-28T17:43:32-04:00May 28, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, MACPAC, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for May 21

The following is the latest health policy news from the federal government for May 15-21. Some of the language used below is taken directly from government documents. Congress The House Ways and Means Committee marked up several health care bills addressing issues such as durable medical equipment (DME) and home health fraud. A discussion draft that would have required non-profit hospitals and health systems to provide additional reporting on community benefit spending was removed from the list of measures considered. See all the marked-up bills and a recording of the meeting on the committee’s website here. Ways & Means expects [...]

joe2026-05-21T16:10:09-04:00May 21, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicaid managed care, Medicaid regulations, Medicare reimbursement policy|

CMS Sets Final ACA Terms for 2027

The Centers for Medicare & Medicaid Services has issued its annual “Notice of Benefit and Payment Parameters for 2027; Basic Health Program,” which governs health plans offered through the federal health insurance exchange and state exchanges as established under the Affordable Care Act. Major provisions under the new final rule include: Eliminating the current requirement that insurers offer standardized health plans at each of the traditional plan levels (bronze, silver, gold, and platinum) in favor of permitting insurers to offer unlimited numbers of plans at each level. Introducing a new non-network plan option in which insurers can now offer exchange [...]

joe2026-05-20T08:07:00-04:00May 20, 2026|Affordable Care Act|