Affordable Care Act

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|

Hospitals Seek Delay in Medicaid DSH Cuts

“Delay upcoming cuts in Medicaid DSH payments” is the message hospitals delivered to Congress recently in response to a reduction of $8 billion in Medicaid disproportionate share cuts scheduled to take effect on October 1. The cuts, mandated by the Affordable Care Act, have been delayed by Congress on several occasions over the years in response to the belief that far more people remain uninsured than was anticipated when the 2010 health care reform law was adopted. According to proponents of the delay, the safety-net hospitals that receive Medicaid DSH payments continue to provide free care to significant numbers of [...]

iqtsupport2023-03-09T06:00:35-05:00March 9, 2023|hospitals, Medicaid disproportionate share, Medicaid DSH|

Health Insurance Markets Remain Highly Concentrated

The health insurance market was highly concentrated in 42 of the 50 states in 2019 and 2020 – the continuation of a trend identified in 2010 that has persisted ever since, according to a new report by the U.S. Government Accountability Office. The GAO considers a market concentrated if three or fewer insurers in a state have 80 percent of that market. Using Centers for Medicare & Medicaid Services health insurance enrollment data, the GAO looked at three distinct aspects of markets – individual policies, small group policies, and large group coverage – and found that Each of the three [...]

iqtsupport2022-11-10T06:00:51-05:00November 10, 2022|Affordable Care Act, Uncategorized|

Federal Health Policy Update for Monday, June 21

The following is the latest health policy news from the federal government as of 2:15 p.m. on Monday, June 21. Some of the language used below is taken directly from government documents. Supreme Court Decision in Affordable Care Act Challenge The Supreme Court upheld the constitutionality of the Affordable Care Act in the California v. Texas case by a 7-2 vote in which the court concluded that the plaintiffs did not have standing to pursue the matter because they were not directly harmed. See the court’s opinion here. White House The White House has posted a transcript of the June [...]

iqtsupport2021-06-21T21:31:34-04:00June 21, 2021|Affordable Care Act, Coronavirus, COVID-19|

Feds Rescind Texas Medicaid Waiver

A federal Medicaid waiver approved for the state of Texas in the waning days of the Trump administration has been rescinded by the Biden administration. The waiver called for spending as much as $100 billion for health care for low-income Texans over the next ten years. Officially, the Centers for Medicare & Medicaid Services revoked the waiver on technical grounds, maintaining that the agency “… erred in exempting the state from the normal public notice process – a critical priority for soliciting stakeholder feedback and ensuring public awareness.” The Washington Post, however, reports that according to two unnamed federal health [...]

iqtsupport2021-04-22T06:00:32-04:00April 22, 2021|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid|