Affordable Care Act

IRS Lays Groundwork for Changes in ACA Premium Tax Credits

The Internal Revenue Service has started the process for redefining who will be eligible for future health insurance premium tax credits for Affordable Care Act health exchange insurance policies. In a recently published notice, the IRS proposes bringing access to those premium tax credits into line with changes adopted in the FY 2025 reconciliation law that introduced major changes in Medicaid eligibility, Affordable Care Act health insurance premium subsidies, and other aspects of federal health care policy. The proposed rule would establish stricter eligibility and enrollment requirements for health premium subsidies – including work/community engagement requirements, income criteria, and immigration [...]

joe2026-10-15T15:42:56-04:00October 19, 2026|Affordable Care Act|

Federal Health Policy Update for September 24

Don’t Miss: CMS plans major cuts in Medicare clinical lab payments Administration reconsiders shifting NIH grant decisions to White House All states enroll in CMS model to reduce prices of selected Medicaid-covered drugs The following is the latest health policy news from the federal government for September 18-24. Some of the language used below is taken directly from government documents. The White House The White House has issued the executive order “Enhancing Program Integrity and Interagency Coordination in the Administration of the H-1B Nonimmigrant Visa Program.” The order increases federal oversight of the H-1B visa program because “The abuse of [...]

joe2026-09-24T15:28:11-04:00September 24, 2026|Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid and homelessness, Medicaid regulations, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 10

Don’t Miss: Energy and Commerce to weigh multiple health care bills HRSA shares upcoming 340B administrative changes CMS continues distributing Rural Health Transformation Program $$$ The following is the latest health policy news from the federal government for September 4-10. Some of the language used below is taken directly from government documents. The White House The White House announced that the federal government will issue refunds of $500 a person to nearly one million Americans who it says were overcharged for Affordable Care Act exchange health plans because their premiums included user fees that were charged to cover the cost [...]

joe2026-09-10T14:54:12-04:00September 10, 2026|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, CMMI, Congress, hospitals, Medicaid, 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|

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|

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|

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|

Impact of Lost Health Insurance Subsidies Already Seen

The expiration of enhanced tax credits for the purchase of health insurance on Affordable Care Act exchanges is expected to put the cost of such plans beyond the reach of approximately 4.8 million people in 2026 and result in a significant increase in uninsured Americans. Just two weeks into the new year, the number of people who have purchased health exchange policies is reportedly 800,000 fewer than last year at this time. For a closer look at the anticipated impact of the loss of Affordable Care Act premium subsidies, see the following articles: NBC News – “ACA sign-ups fall as [...]

joe2026-01-13T15:17:01-05:00January 14, 2026|Affordable Care Act|

Federal Health Policy Update for January 8

The following is the latest health policy news from the federal government for December 29 to January 8. Some of the language used below is taken directly from government documents. Congress Congress returned from winter recess facing a full policy agenda and health care issues remain prominent. Following the expiration of the Affordable Care Act’s enhanced premium tax credits, the House is expected to vote on a three-year clean extension brought by a discharge petition from Democratic House Leader Hakeem Jefferies (D-NY). The Senate is unlikely to advance the measure but a bipartisan group of senators is developing an alternative: [...]

joe2026-01-08T15:32:32-05:00January 8, 2026|340b, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for December 18

The following is the latest health policy news from the federal government for December 12-18. Some of the language used below is taken directly from government documents. Congress In a 216-211 vote yesterday, the House passed the Lower Health Care Premiums for All Americans Act, a Republican package aimed at addressing multiple health care policies. The legislation includes provisions for employee tax-advantaged benefits like HSAs and FSAs, cost-sharing reductions (CSR) subsidies, and increased transparency requirements for pharmacy benefit managers (PBMs). It notably did not include an extension of the enhanced Affordable Care Act premium tax credits that many of the [...]

joe2025-12-18T16:29:43-05:00December 18, 2025|Accountable Care Organization, ACO, Affordable Care Act, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|