Affordable Care Act

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|

Some States Step in to Help Offset Health Exchange Changes

Enhancing existing state subsidies to help pay health insurance premiums. Replacing lost premium tax credits. Reducing monthly premiums. Extending subsidies to some middle-income individuals and families. Mitigating the loss of eligibility for lawfully present immigrants. These are among the steps that some state governments have taken to try to offset the impact of changes in Affordable Care Act health exchange eligibility and insurance premium assistance that took effect on January 1. Learn more about these and other mostly one-year fixes from the Commonwealth Fund report “Some States Blunted the Impact of Lost Federal Marketplace Subsidies, But Efforts Will Be Hard [...]

joe2026-04-21T16:49:34-04:00April 22, 2026|Affordable Care Act|

ACA Premium Subsidy Talks Over?

Negotiations seeking to strike a compromise in the elimination of enhanced subsidies for lower-income purchasers of health plans sold on Affordable Care Act insurance exchanges appear to have died a quiet death. Talks between Democratic and Republican negotiators focused on a one- or two-year extension of those subsidies, but once the subsidies ended at the close of 2025 and then Congress enacted an FY 2026 funding bill for the Department of Health and Human Services, those talks appeared to collapse. Learn more about the issues that negotiators stumbled over and how those talks faltered and ultimately failed from the Wall [...]

joe2026-02-12T14:39:00-05:00February 13, 2026|Affordable Care Act|

Federal Health Policy Update for February 12

The following is the latest health policy news from the federal government for February 6-12. Some of the language used below is taken directly from government documents. The White House The White House announced the launch of TrumpRx, a service that will enable consumers to purchase a limited number of discounted prescription drugs directly from the manufacturers of those drugs and in some cases from pharmacies without the benefit of health or prescription drug insurance. Learn more about TrumpRx and its launch from this White House announcement, an accompanying fact sheet, and the TrumpRx web site. Congress Following passage of [...]

joe2026-02-12T16:12:39-05:00February 12, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Proposes Major Changes in Exchange Plans

The Centers for Medicare & Medicaid Services has proposed sweeping changes in the health plans offered by Affordable Care Act marketplace exchanges. The changes, revealed in CMS’s proposed Notice of Benefit and Payment Parameters for 2027, affect both the regulations governing the types of health plans that can be offered on exchanges and how potential buyers of those plans are deemed eligible for those plans. The major changes include: Permitting insurers to offer catastrophic plans with terms of either one year or multiple consecutive years, up to ten years. Repealing standardized plan options and related limit requirements. Permitting low-deductible plans [...]

joe2026-02-11T12:46:23-05:00February 12, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services|

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 the expired insurance premium subsidies. Learn more about the challenges [...]

joe2026-02-05T15:07:41-05:00February 9, 2026|Affordable Care Act, hospitals, Medicaid|

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) allotments to the states for both FY 2026 and FY [...]