Affordable Care Act

Federal Health Policy Update for August 20

Don’t Miss: Latest No Surprises Act/Independent Dispute Resolution news Dept of Homeland Security issues guidance on “public charge” The following is the latest health policy news from the federal government for August 14-20. Some of the language used below is taken directly from government documents. Congress Thirty Senate Democrats have written to HHS Secretary Kennedy seeking to reverse the cancellation of health research grants administered by the Agency for Healthcare Research and Quality (AHRQ). For more information, see the letter here. Congress remains in recess; the House is expected to return on August 31 and the Senate on September 14. [...]

joe2026-08-20T15:55:42-04:00August 20, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Loss of Insurance Options Hitting Hospital Bottom Lines

Hospitals are starting to feel the impact of the loss of enhanced subsidies for the purchase of Affordable Care Act health insurance plans. According to officials from a number of for-profit hospital companies, they have been surprised at how few patients who lost their Affordable Care Act enhanced premium subsidies have purchased alternative coverage, leaving them uninsured instead. Nearly three million fewer people purchased insurance through Affordable Care Act exchanges this year than last year. Such individuals continue to turn to hospitals for care – increasingly, for care they put off because they were uninsured, resulting in greater acuity. Hospitals [...]

joe2026-08-05T12:54:53-04:00August 7, 2026|Affordable Care Act, hospitals|

Federal Health Policy Update for July 30

Don’t Miss: Two new final Medicare payment rules CMS seeks data on 340B prescriptions Agency seeks potentially confidential ER data The following is the latest health policy news from the federal government for July 24-30. Some of the language used below is taken directly from government documents. Congress Senate Republicans remain focused on advancing a short-term continuing resolution (CR) before the August recess; it is expected to differ from the CR the House passed last week. The Senate appears unlikely to consider a budget resolution for a third party-line reconciliation bill before September. The Senate Budget Committee announced a hearing [...]

joe2026-07-30T15:52:57-04:00July 30, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

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|