Affordable Care Act

Federal Health Policy Update for December 11

The following is the latest health policy news from the federal government for December 5-11. Some of the language used below is taken directly from government documents. Congress The Senate voted today on competing proposals to address health care affordability: Democrats sought a clean extension of the Affordable Care Act premium tax credits set to expire on December 31 while Republicans tried to consolidate support around an alternative plan. Neither bill gained the 60-vote threshold needed for passage. In the House, Speaker Mike Johnson (R-LA) intends to bring a vote on a health care package next week but at this [...]

joe2025-12-11T15:48:53-05:00December 11, 2025|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 4

The following is the latest health policy news from the federal government for November 21 through December 4. Some of the language used below is taken directly from government documents. Congress Congress is back in session to discuss the Affordable Care Act tax credits set to end on December 31and other extenders that will expire on January 30, 2026 along with the latest continuing resolution (CR). Members continue to negotiate potential solutions to the expiring enhanced Affordable Care Act premium subsidies but there is no consensus on whether or how to address the expiring benefit. Senate Majority Leader Thune (R-SD) [...]

joe2025-12-04T15:05:28-05:00December 4, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Health Care and the End of the Shutdown

Passage last week of a continuing resolution to fund the federal government brought the 43-day shutdown to an end – and relief for many health care organizations and the people and communities they serve. The final continuing resolution, which extended federal funding through the end of January of next year, includes: Restoring the delay of reductions of Medicaid disproportionate share hospital (Medicaid DSH) payments. Extending authorization for the Medicare Acute Hospital Care at Home program and Medicare telehealth flexibilities. Extending the low-volume hospital adjustment program and the Medicare-dependent hospital program all through that same date. The bill waives the pay-as-you-go [...]

joe2025-11-13T16:30:32-05:00November 17, 2025|Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for November 6

The following is the latest health policy news from the federal government for October 31 – November 6. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown; some are engaging in limited exceptions. Congress and the Shutdown Senate Majority Leader John Thune (R-SD) today told his caucus that he plans to bring the House-passed CR to yet another vote in the Senate on [...]

joe2025-11-06T21:35:12-05:00November 6, 2025|340b, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 30

The following is the latest health policy news from the federal government for October 24-30. Some of the language used below is taken directly from government documents. Please note that most HHS and other health care-related agencies have indicated that they will not be announcing new policies, publishing proposed regulations, or updating their web sites during the current federal government shutdown. Congress and the Shutdown The federal government remains shut down and the Senate expects to leave Washington today without another vote on the House-passed continuing resolution (CR), ensuring that the shutdown will continue into next week. Republican leaders believe [...]

joe2025-10-31T12:15:23-04:00October 30, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, Medicaid, Medicare|

Medicaid DSH Cuts Have (Seemingly) Arrived

Cuts in Medicaid disproportionate share payments, mandated in 2010 under the Affordable Care Act to take effect in 2014 but delayed by Congress ever since, are now scheduled to begin taking effect because Congress’s latest extension of the delay lapsed with the end of the federal fiscal year on September 30. As a result, states – and hospitals that qualify for Medicaid DSH – are expected to see federal Medicaid DSH spending slashed by $8 billion a year for the next three years. Medicaid DSH payments are made to selected hospitals based on how many low-income patients they serve who [...]

joe2025-10-15T11:42:36-04:00October 16, 2025|Affordable Care Act, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

If ACA Funding for Medicaid Expansion Were to be Cut…

When Congress enacted the Affordable Care Act in 2010 it offered states a powerful incentive to expand their criteria for Medicaid eligibility: money to pay for most of that expansion. Under that law, the federal government pays 90 percent of the cost of providing Medicaid-covered services to individuals who became eligible for the program under the expanded criteria. So far, 41 states and the District of Columbia have taken advantage of this enhanced funding and 11 million additional people have enrolled in the Medicaid program as a result. But what would happen if that enhanced federal Medical Assistance percentage – [...]

joe2025-03-13T17:26:22-04:00March 17, 2025|Affordable Care Act, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH|

The Implications of Eliminating the ACA Medicaid Expansion Matching Rate

When the Affordable Care Act was adopted in 2010 it offered a powerful incentive for states to expand their Medicaid program: the federal government would pick up 90 percent of the cost of covering each state’s expansion population. Over the years, 40 of the 50 states have taken advantage of these terms to expand their Medicaid programs, resulting in a significant increase in both Medicaid enrollment and how much the federal government spends on Medicaid. Now, policymakers are considering ending that incentive, leaving the 40 states with a difficult choice: to pick up the additional cost themselves or reverse their [...]

joe2025-02-13T17:13:28-05:00February 18, 2025|Affordable Care Act, Congress, Medicaid|

Medicaid Expansion in Jeopardy?

The Affordable Care Act’s Medicaid expansion resulted in 40 of the 50 states (and the District of Columbia) expanding their Medicaid programs because of the health reform law’s promise of additional federal funding to help pay for care for the expansion population. But now, with Congress and the new administration contemplating spending cuts that may include reductions in the federal financial commitment to Medicaid, a number of states may soon reverse those Medicaid expansions. Expansion repeal efforts are already underway in Idaho, Montana, and South Dakota. Nine states – Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah, and [...]

joe2025-02-11T16:11:32-05:00February 12, 2025|Affordable Care Act, Congress, Medicaid|

Congress Spares Medicaid DSH Cut – for Now

An oft-delayed cut in Medicaid disproportionate share allotments to states was delayed once again in the latest temporary spending bill passed by Congress last week. The stopgap spending bill, which runs until March 8, delays an $8 billion a year cut in Medicaid DSH payments that was part of the Affordable Care Act and has been put off by Congress on numerous occasions ever since. The reduction was envisioned as an appropriate move in anticipation of a significant increase in uninsured Americans after the 2010 reform law’s passage. While that increase has occurred, many hospitals continue to care for significant [...]

joe2024-01-23T19:58:33-05:00January 23, 2024|Affordable Care Act, Medicaid, Medicaid DSH, Medicaid DSH allotments|