Marketplace Issues/Stability
The enhanced premium tax credits (EPTCs) help middle-class Americans purchase affordable, comprehensive coverage on the Health Insurance Marketplace. These tax credits are set to expire at the end of 2025, putting millions of families at risk of higher costs and coverage losses.
The AHA Aug. 28 published a blog responding to a series of reports from the Paragon Health Institute alleging large-scale “fraud” in health care, this time focusing on enrollment in the Health Insurance Marketplace.
It is imperative that policymakers understand that Paragon developed their allegations of large-scale “fraud” in health care using inaccurate data, dubious assumptions, and an apparent lack of understanding of how health insurance actually works.
Health Insurance Marketplace insurers will propose a median premium increase of 15% for 2026, according to an analysis of preliminary rate filings published July 18 by the Peterson Center on Healthcare and KFF.
AHA President and CEO Rick Pollack joined me for a Leadership Dialogue conversation to help us understand the key provisions that apply to health care.
The Centers for Medicare & Medicaid Services June 20 finalized its 2025 Marketplace Integrity and Affordability rule, intended to establish new standards for the health insurance marketplaces and address improper and fraudulent enrollments.
The Senate Committee on Finance has released bill text for its portion of the budget reconciliation bill. It appears that the provisions further undermine the ability for hospitals to provide care to Medicaid patients.
The House-passed One Big Beautiful Bill Act (OBBBA, H.R. 1) makes significant changes to the Affordable Care Act (ACA) marketplaces that would lead to millions of people losing their coverage and becoming uninsured.
House passes reconciliation bill with significant impacts to Medicaid, Health Insurance Marketplaces
The House May 22 passed the fiscal year 2025 budget reconciliation bill, the One Big Beautiful Bill Act by a 215-214 vote. The legislation includes significant impacts to Medicaid and the Health Insurance Marketplaces.
This is a summary of provisions included in the One Big Beautiful Bill Act that affect hospitals and health systems, as well as some resources from the Congressional Budget Office regarding the impact of the bill.