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|

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|